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Coughing and choking in motor neuron disease

Hadjikoutis, S., Eccles, Ronald and Wiles, Charles Mark 2000. Coughing and choking in motor neuron disease. Journal of Neurology, Neurosurgery & Psychiatry 68 (5) , pp. 601-604. 10.1136/jnnp.68.5.601

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Abstract

OBJECTIVES To assess the frequency and severity of coughing and choking episodes, possible related factors, and their association with chest infections in patients with motor neuron disease (MND). METHODS Thirty seven patients with MND and 23 healthy volunteers were studied. Cough was assessed using a questionnaire and a 3 day diary, and volitional cough quantified by peak cough flow and sound intensity. Other clinical symptoms, smoking habit, affective state, oral secretions, bulbar signs, and quantitative assessments of swallowing and respiratory function were documented. RESULTS Patients with MND coughed and choked significantly more often and to a greater degree than the healthy volunteers (26 of 37 patients with MND and 2 of 23 volunteers, p<0.001). Female sex, older age, abnormal speech, reduced swallowing capacity, and low forced vital capacity (FVC)% predicted were each significantly associated with excessive coughing and choking episodes in patients with MND. Smokers had significantly more severe and prolonged episodes of coughing and choking than non-smokers (p<0.05). Patients with upper motor neuron bulbar signs had a greater tendency to severe and prolonged episodes of coughing and choking than those without (p<0.05). Chest infections were reported only rarely among the patients who coughed and choked. CONCLUSIONS Coughing and choking episodes are common in patients with MND but infrequently associated with overt chest infection. Upper motor neuron bulbar signs may both promote factors (for instance, dysphagia) which trigger cough and reduce volitional capacity to suppress it.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Medicine
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RF Otorhinolaryngology
Publisher: BMJ Publishing Group
ISSN: 0022-3050
Last Modified: 04 Jun 2017 08:02
URI: http://orca.cf.ac.uk/id/eprint/71828

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