La toux diabolique: neurogenic tussive crisis

A 52 year old female non-smoker with multiple sclerosis had a 10 year history of frequent diurnal and nocturnal spontaneous attacks of coughing, relapsing and remitting, with typical symptoms of her illness. Otolaryngeal evaluations failed to show any lesions or vocal cord paresis, and her cardiopulmonary examinations were normal. Her attacks were greatly improved by carbamazepine and valproate sodium. I suggest that tussive crisis constitutes a paroxysmal symptom in multiple sclerosis, amenable to treatment with anticonvulsant agents.