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Q J Med 1999; 92: 487-494
© 1999 Association of Physicians

Review

Cough in motor neuron disease: a review of mechanisms

S. Hadjikoutis, C.M. Wiles and R. Eccles1

From the Department of Medicine (Neurology), University Hospital of Wales, and 1 The Common Cold Centre, Cardiff School of Biosciences, Cardiff University, Cardiff, UK

Dr S. Hadjikoutis, Department of Neurology, University Hospital of Wales, Heath Park, Cardiff CF4 4XN


   Introduction
 
For patients with neuromuscular diseases which affect breathing and swallowing, coughing and choking are frightening and distressing symptoms sometimes perceived (correctly) as life-threatening. Cough is an important function of the larynx and respiratory system which allows an individual to clear the airway of foreign material and secretions and prevent aspiration of food and fluid. Choking is the feeling of strangulation or suffocation which may result from the presence of foreign material in the airway, often accompanied by airway obstruction so that there is an inability to draw breath.

Motor neuron disease (MND) is a progressive degenerative disorder of the nervous system affecting the anterior horn cells of the spinal cord, the motor nuclei of the brain stem, and the corticospinal tracts. For MND patients, airway obstruction, aspiration and pneumonia are major causes of morbidity and mortality; episodes of coughing and choking are commonly reported by patients, and presumably represent episodes . . . [Full Text of this Article]


   The cough reflex
 
Sensory limb
Central control of the cough reflex
Efferent limb

   Motor neuron disease
 
Sensory limb
Central control
Efferent limb
Inspiratory capacity
Glottis closure
Expiratory muscle strength
Conclusion

   Acknowledgments
 

   References
 

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