PMID: 9527156Apr 4, 1998Paper

Cough responsiveness in neurogenic dysphagia

Journal of Neurology, Neurosurgery, and Psychiatry
P E Smith, C M Wiles

Abstract

In neurogenic dysphagia a good cough is important for airway protection. If triggering of cough, or its effectiveness, is impaired this might result in an increased aspiration risk. Capsaicin, an agent which induces cough through sensory nerve stimulation, was used to test cough sensitivity in groups of patients with and without neurogenic dysphagia. On the basis of swallowing speed (ml/s) in a validated water test 28 alert neurological inpatients (16 women, aged 22-71 years) were classified into 13 with abnormal and 15 with normal swallowing (median swallowing speed 23% and 99%, median volume/swallow 43% and 106% of that predicted for age and sex respectively: p<0.001). Capsaicin nebulised on air in saline was inhaled via a low resistance valve using a mouthpiece and noseclip. Up to seven incremental concentrations of capsaicin ranging from 0.07-20.0 x 10(-4) mol/l were each inhaled for up to a minute. A pneumotachograph connected to the expiratory limb gave a paper recording of expiratory air flow. Coughs were recorded as high flow expirations of short duration. Capsaicin concentrations at first cough (threshold) were recorded; concentrations at frequencies of 10 and 20 coughs/minute were interpolated from the dose-response c...Continue Reading

Citations

Apr 13, 2006·Aging Clinical and Experimental Research·Stefano MasieroMarco Ortolani
Jul 12, 2002·Journal of the American Geriatrics Society·Li-Chan LinMiao-Yen Chen
Jan 11, 2000·QJM : Monthly Journal of the Association of Physicians·S HadjikoutisR Eccles
Nov 22, 2011·Revue des maladies respiratoires·F PuisieuxUNKNOWN Intergroupe PneumoGériatrie SPLF–SFGG placé sous l’égide de la Société de pneumologie de langue française (SPLF) et de la So
Nov 2, 2014·Journal of Movement Disorders·Cumhur Ertekin
Jul 9, 2005·Chest·Peter V Dicpinigaitis, Rakesh V Alva
Sep 13, 2003·Chest·Satoru EbiharaHidetada Sasaki
Oct 13, 2010·Pulmonary Pharmacology & Therapeutics·Satoru Ebihara, Takae Ebihara
Feb 20, 1999·Archives of Physical Medicine and Rehabilitation·W R AddingtonM Rodriguez
Jun 22, 1999·AIDS Patient Care and STDs·S SwindellsH E Gendelman

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