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Cough responsiveness in neurogenic dysphagia
1Department of Medicine (Neurology), University of Wales College of Medicine, Cardiff, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|April 4, 1998
Summary
Patients with neurogenic dysphagia show enhanced cough responsiveness, contrary to expectations. This suggests their cough triggering sensitivity is not reduced, potentially aiding airway protection despite swallowing difficulties.
Area of Science:
- Neurology
- Pulmonology
- Gastroenterology
Background:
- Neurogenic dysphagia impairs airway protection due to compromised cough reflex.
- Assessing cough sensitivity is crucial for managing aspiration risk in these patients.
Purpose of the Study:
- To evaluate cough sensitivity using capsaicin in patients with and without neurogenic dysphagia.
- To determine if neurogenic dysphagia affects the cough reflex threshold and responsiveness.
Main Methods:
- 28 neurological inpatients were classified based on swallowing speed using a validated water test.
- Capsaicin inhalation via nebulizer was used to determine cough threshold and frequency.
- Cough responses were measured using a pneumotachograph to record expiratory airflow.
Main Results:
- Cough threshold and the concentration of capsaicin producing 10 or 20 coughs/minute tended to be lower in patients with abnormal swallowing.
- These trends, while not statistically significant, suggest a potential enhancement in cough responsiveness.
Conclusions:
- Contrary to expectations, cough responsiveness appears enhanced in alert patients with neurogenic dysphagia.
- These findings indicate that neurogenic dysphagia patients do not necessarily have reduced cough triggering sensitivity.