the diagnosis of hemi-laryngopharyngeal spasm, like any medical condition, can be made by history, physical examination and special tests. the history of symptoms will be reported by the patient and should match the descriptions provided above. a few unique features of this condition are the eventual presence of symptoms while sleeping and (for those with pharyngeal involvement) an obviously unilateral presentation. physical examination will be normal in between episodes. examination during an episode is difficult because the patients are in extremis. a number of special tests have been investigated.