From the Research
Neurogenic cough does exist, and it is a chronic cough condition caused by hypersensitivity or dysfunction of the nerves involved in the cough reflex, particularly the vagus nerve, as supported by the most recent study in 2024 1.
Definition and Pathophysiology
Neurogenic cough is thought to be related to sensory neuropathy in the hypopharynx and larynx, and it is defined as a cough persisting longer than 8 weeks refractory to standard therapy, with a diagnosis of exclusion when other common etiologies are ruled out 1. This condition affects roughly 11% of Americans and can negatively impact quality of life.
Treatment Options
Treatment options for neurogenic cough include neuromodulator medications, cough suppression therapy, superior laryngeal nerve (SLN) block, and laryngeal botulinum toxin injections, with a stepwise multimodal approach showing effective results in a recent study 1. Some key points to consider:
- Neuromodulators such as gabapentin, pregabalin, or amitriptyline may be used, as suggested by previous studies 2, 3, 4.
- Speech therapy techniques focusing on cough suppression exercises and behavioral strategies can also be effective.
- A trigger-reduction approach using nasal toilet and a plant-based diet may be considered before initiating systemic neuromodulating medications, as shown in a 2019 study 5.
Diagnosis and Quality of Life
Neurogenic cough is often diagnosed after excluding other common causes of chronic cough, and it can significantly impact quality of life, causing physical discomfort, social embarrassment, and psychological distress. A multimodal approach to treatment is typically required, and patients may need to try different therapies before finding effective relief, as supported by the most recent evidence 1.