Cough as a neurological sign: Does it worth it?

Abstract

Cough is one of the most common complaints that lead patients to see a\ndoctor. It is not only a basic respiratory sign but also an important\nneurological sign. There are 3 main types of cough: reflex cough (type\nI), voluntary cough (type II), and evoked cough (type III). Reflex cough\nsensitivity may be increased in many neurological disorders, such as\nspace-occupying lesion of the brainstem, medullary lesions secondary to\ntype I Chiari malformations, tics disorders such as Tourette’s syndrome,\nsomatic cough, neurodegenerative disorders of the cerebellum, and\nchronic vagal neuropathy due to allergic and nonallergic diseases. On\nthe other hand, cough sensitivity decreases in the cerebral hypoxia,\ncerebral hemispheric stroke with a brainstem shock, dementia due to Lewy\nbody disease, Parkinson’s disease, amyotrophic lateral sclerosis,\nmultiple sclerosis, and peripheral neuropathy such as hereditary sensory\nand autonomic neuropathy type IV, diabetic neuropathy, vitamin B12, and\nfolate deficiency. The ear-cough reflex of Arnold’s nerve, syncopal\ncough, cough headache, opioid associated cough and cough-anal reflex are\nsigns that can help in the diagnosis of underlying neurological\ndisorders. The cough reflex test is a quick, easy, and inexpensive test\nthat can be performed during the cranial nerve exam. In this article, we\nhave discussed cough reflex testing and various neurological disorders\nthat increase or decrease cough sensitivity.