Coughing and Unconsciousness

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LARYNGEAL VERTIGO is a dramatic syndrome, first described by Charcot1 in 1876, in which coughing produces unconsciousness with or without convulsions. At times only giddiness follows the cough which is attributed to spasm of the larynx with closure of the glottis. The cough is reported to be distinctive in character and is usually preceded by a tickling sensation in the throat. In some cases the cough is mild. The syndrome occurs most commonly in middle aged men. They are described as being plethoric, emphysematous, or having a tendency to hypertension. There is a frequent association with laryngitis or bronchitis. Many physicians are unaware of the existence of such a condition.

The syndrome is not rare. Whitty2 reviewed the literature in 1943 and reported approximately 85 cases. Many cases have not been reported because as Rook3 says, “They do not get past the general practitioner who adopts a very reasonable ‘wait and see’ attitude,” the attack often not being repeated. In the past year one of us, on a general diagnostic service, has seen two examples of this syndrome. Adams4 reports that 3 such cases were referred to him by a single physician within a period of a few months.

Case Reports

Case 1. A 43-year-old coal miner was seen at the Cleveland Clinic February 19, 1948. He complained that he had “blacked out” after coughing on 8 occasions during the past four years. He coughed violently until he “got blue in the face” and fell unconscious to the floor. He. . .



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