Hysterical stridor: a diagnosis of exclusion.

Two stridorous patients who presented to the emergency department with respiratory distress are discussed. Thorough history, physical examination, and direct visualization of the larynx failed to detect any anatomical upper airway abnormalities; therefore, the etiology of airway obstruction in both patients was determined to be psychogenic. Stridor caused by psychogenic causes is uncommon and, probably, underrecognized. Stridor caused by structural and pathological causes must be considered and excluded before it can be attributed to psychogenic causes, thereby making this a diagnosis of exclusion.