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Article
September 1993

Cause for Intractable Chronic Cough: Arnold's Nerve

Author Affiliations

Westerly, RI

Arch Otolaryngol Head Neck Surg. 1993;119(9):1042. doi:10.1001/archotol.1993.01880210136018
Abstract

A recent admission to our hospital might serve as a notice to our colleagues of a rather unusual cause for intractable chronic cough.

The patient was an 11-year-old white boy with a long history of cough variant asthma. His predominant symptom was a nonproductive, intractable cough that produced insomnia, fatigue, and hoarseness. Several emergency department evaluations and four hospital admissions ensued over a 5-week period. Results of radiographic evaluations including a sinus series, barium swallow, and chest roentgenograms were normal. A pediatric allergist was consulted by the primary care physician. A wide range of medications including antibiotics, corticosteroids (intravenous, oral, inhalers), narcotics, β2-agonists, cromolyn sodium, theophylline, and tranquilizers were used to treat presumed allergic, asthmatic, infectious, and neuropsychotic causes. None proved successful in ameliorating the patient's symptoms.

On the patient's fourth and final hospital admission an otolaryngology consultation was obtained to evaluate the patient's increasing hoarseness. A fiberoptic

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