Part II: Coughing That Won't Go Away: Sensory Neuropathic Cough

Sensory neuropathic cough is a chronic cough condition that does not respond to the usual treatments. Many individuals who have been coughing for years can find relief through treatment with "neuralgia" medications. See also www.bastianvoice.com

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• gabapentin
• amitriptyline
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[redholmar]

thank you doctor, thank you a lot

But i afraid of treating it with antidepressor as i think can be really dangerous in term of sevrage isn t it?

[BVI03]

@redholmar Side effects of Elavil vary & may subside with time. Most require 10 to 50 mg only, but just saw a return patient getting great results with 100 mg a day and NO side effects at all. Not even dry mouth or grogginess. If SE are intolerable, then move to gabapentin. Dose required often 300 mg TID or QID (start with one per day and increase by 300 mg every 3 days) A few require very high doses indeed--my highest so far is 1600 mg 4x a day or 4800 mg per day.  Again, SE variable

[bhawmik]

Dear Dr. Bastian,

Thanks for these wonderful informative videos.

I have a few questions.

1. Can SNC result in vocal cord paresis?

2. Can SNC and asthma/COPD co-exist? How can one have a differential diagnosis?

3. Does SNC respond to corticosteroids or broncho-dilators?

4. Is there any relationship between SNC and VCD (Vocal Cord Dysfunction) that can also mimic asthma?

5. Do you know of any doctor in NJ who has experience with SNC?

[BVI03]

Hello, sorry I can't keep up with comments. I'd suggest you try Dr. Altman at Mt. Sinai in NYC. SNC is more common IF a person has paresis; SNC could coexist with another disorder, but problem is misdx . . . SNC often responds transiently to steroids, but not to bronchodilators. VFD is functional (non-organic) and SNC is neurological.  Best wishes!

[rmwagoner03]

would this class of drugs work for someone with vocal cord dysfunction that happens after a viral infection or post viral vagus nerve neuropathy? Would it help the trouble breathing?

thank you

Morgan

[lm2942]

Dr. Bastian,

I finally found a name for all the symptoms I have had for over a year! When I asked my ENT if this could be what I have, he dismissed it because I have had a chronic sinus infection which has not gone away even with surgery. Is it possible to have SNC if there is a sinus infection present as well? I am already taking Effexor so maybe I don't have SNC.

[quicknuss]

Amazing! I now know why my cough improved after taking Gabapentin for neuropathy and radiculopathy.  Are these conditions curable?

[arfx3]

Dr. Bastian, Can a symptoms of this be tightness in the muscles around the hyoid ( suprahyoid and infrahyoid) bone and supraclavicle tightness? Can snc be confused with acid reflux or mildly respond to reflux meds?

[koala8]

I only get this type of coughing after a recovery from an infection of influenza/common cold....it last for a couple of weeks and then it goes away...but I get it at least once a year for a couple of weeks only..should the suggested treatments be applicable to that kind of scenario as well?

[modublin22]

I just got diagnosed with this and got prescribed elavil. Horrible. Heart raced had to be rushed to ER. Only on 10 mg. Doc is going to try something next week. Does this ever get better or will I have to take medication for the rest of my life? I am on a liquid diet and would love to have more kids in the future. This has been a horrible thing to deal with as solid foods really trigger it for me.

[blc341]

the differential diagnosis for sensory cough is asthma brought on by heartburn(or LPR silent reflux), GERD, or indigestion, because acid from your stomach can wear away at your respiratory tract leading to scratchy throat, and chronic coughing. you did mention ashtma, but it was not an actual descript description.

im sorry but first line treatment listing gabapentin is a good choice, but gabapentin has awful side effects. it's ok at first but can lead to being fat and cognitive deficits.

[LongBeachRE]

Dr. Bastain,

You treat my sister currently and she suggested I look at your website and watch this video, it sounds exactly what i have been experiencing for the past 1.5 years. I live in Long Beach, CA and was wondering if you had any referrals in the Los Angeles or Orange cty areas for a dr. or group of dr's with the knowledge of SNC. Any feed back is greatly appreciated.