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Cough as a neurological sign: Does it worth it?

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