Cough as a neurological sign: What a clinician should know

Al‐Biltagi, Mohammed; Bediwy, Adel Salah; Saeed, Nermin Kamal

doi:10.5492/wjccm.v11.i3.115

Cited by 9 publications

(12 citation statements)

References 79 publications

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“…Since there is a wide range of disorders that can have similar clinical manifestations, including respiratory and digestive pathologies, differentiating true coughing from gagging and dysphagia can be challenging and relies upon detailed history taking 20,21 . Primary central neurological causes of pharyngeal and/or laryngeal disorders, although exceedingly rare, can be encountered in human medicine and are often a diagnosis of exclusion 22 . Coughing as the initial symptom of primary central neurogenic disease has been described in people with lymphoma of the brainstem, other space‐occupying brainstem lesions, and in Chiari I malformations with pathological impingement of the medullary region of the brainstem 23–25 …”

Section: Discussionmentioning

confidence: 99%

Computed tomographic features of canine intracranial and jugular foraminal masses involving the combined glossopharyngeal, vagus, and accessory nerve roots

Lluesma,

Whitley,

Hughes

2024

Vet Radiology Ultrasound

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A chronic cough, gag, or retch is a common presenting clinical complaint in dogs. Those refractory to conservative management frequently undergo further diagnostic tests to investigate the cause, including CT examination of their head, neck, and thorax for detailed morphological assessment of their respiratory and upper gastrointestinal tract. This case series describes five patients with CT characteristics consistent with an intracranial and jugular foraminal mass of the combined glossopharyngeal (IX), vagus (X), and accessory (XI) cranial nerves and secondary features consistent with their paresis. The consistent primary CT characteristics included an intracranial, extra‐axial, cerebellomedullary angle, and jugular foraminal soft tissue attenuating, strongly enhancing mass (5/5). Secondary characteristics included smooth widening of the bony jugular foramen (5/5), mild hyperostosis of the petrous temporal bone (3/5), isolated severe atrophy of the ipsilateral sternocephalic, cleidocephalic, and trapezius muscles (5/5), atrophy of the ipsilateral thyroarytenoideus and cricoarytenoideus muscles of the vocal fold (5/5), and an ipsilateral “dropped” shoulder (4/5). Positional variation of the patient in CT under general anesthesia made the “dropped” shoulder of equivocal significance. The reported clinical signs and secondary CT features reflect a unilateral paresis of the combined cranial nerves (IX, X, and XI) and are consistent with jugular foramen syndrome/Vernet's syndrome reported in humans. The authors believe this condition is likely chronically underdiagnosed without CT examination, and this case series should enable earlier CT diagnosis in future cases.

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Section: Discussionmentioning

confidence: 99%

Computed tomographic features of canine intracranial and jugular foraminal masses involving the combined glossopharyngeal, vagus, and accessory nerve roots

Lluesma,

Whitley,

Hughes

2024

Vet Radiology Ultrasound

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“…can still result in pronounced nocturnal coughing [ 5 ]. The presence or absence of nocturnal cough cannot be used as the sole basis for diagnosis; somatic cough syndrome can only be diagnosed when a patient meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria [ 3 , 5 ]. In this case, although it is evident that the cough has persisted for a long time and has caused significant stress, with a notable impact on the patient's emotions, there are no records of psychiatric assessments before or after the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Oversensitivity of the vagus nerve is considered one of the main factors in chronic neurogenic cough [ 3 , 13 ]. The Arnold nerve reflex induces a cough reflex by stimulating a branch of the vagus nerve in the ear.…”

Section: Discussionmentioning

confidence: 99%

“…In the treatment of chronic cough, commonly employed methods include pharmacotherapy and behavioral therapy. Pharmacotherapy primarily aims to control the cough reflex, utilizing medications such as antidepressants, antispasmodics, and sedatives [ 3 , 6 ]. Behavioral therapy encompasses cognitive behavioral therapy and breathing exercises, aiding patients in altering their response to coughing and their perception of pain [ 3 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacotherapy primarily aims to control the cough reflex, utilizing medications such as antidepressants, antispasmodics, and sedatives [ 3 , 6 ]. Behavioral therapy encompasses cognitive behavioral therapy and breathing exercises, aiding patients in altering their response to coughing and their perception of pain [ 3 , 7 ]. Additionally, nerve block techniques may be employed to attenuate neurogenic chronic coughs resulting from excessive nerve activation [ 3 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cervical Manipulation and Koren Specific Technique Emotions Protocol in the Improvement of Intensive Nocturnal Dry Cough: A Case Report

Chang

2024

Cureus

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This report describes a 42-year-old female patient who presented with an intensive nocturnal dry cough persisting for over six months. Subsequent to the prolonged cough, she developed shoulder and neck discomfort, leading her to seek chiropractic care. The patient received cervical chiropractic adjustments combined with the Koren Specific Technique (KST) emotions protocol. The patient was mainly treated for her musculoskeletal complaint. However, after two treatment sessions, the patient's chronic cough showed significant improvement. Two weeks later, the cough had completely ceased, and her shoulder and neck discomfort had also improved. The cough symptoms did not reappear during the six-month follow-up. The mechanism of cough improvement remains unclear, whether it is due to spinal adjustments, the KST emotions protocol, their combined effects, or merely a placebo response. This report discusses the potential underlying mechanisms of the case improvement, suggesting a non-pharmacological adjunctive therapeutic approach that could be investigated further in future research.

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Neural Mechanisms Underlying the Coughing Reflex

Lu,

Cao

2023

Neurosci. Bull.

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Cough as a neurological sign: What a clinician should know

Cited by 9 publications

References 79 publications

Computed tomographic features of canine intracranial and jugular foraminal masses involving the combined glossopharyngeal, vagus, and accessory nerve roots

Computed tomographic features of canine intracranial and jugular foraminal masses involving the combined glossopharyngeal, vagus, and accessory nerve roots

Cervical Manipulation and Koren Specific Technique Emotions Protocol in the Improvement of Intensive Nocturnal Dry Cough: A Case Report

Neural Mechanisms Underlying the Coughing Reflex

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