Tic disorders in the differential diagnosis of chronic cough in children. Clinical cases
Medical Review (Med. pregled), 2024, 60(1), 59-62.
E. Stoeva1,2, R. Markova1,2
1 First Pediatric Consultative Clinic – Sofia
2 Medical University – Pleven
Abstract. Coughing is an important defensive reflex that enhances clearance of secretions and particulates from the airways. It is often an alarming symptom in childhood, and a reason for consultations with a pediatrician and a pediatric pulmonologist. Acute cough is defined as cough resolving within 3 weeks. Most often, it is caused by infection of the upper or lower respiratory tracts. A cough that lasts for more than four weeks is called a chronic cough. Common causes of chronic cough include allergic rhinosinusitis, bronchial asthma, GERD, bronchiectasis, use of certain medications such as ACE inhibitors, heart failure, pulmonary tuberculosis and sarcoidosis, psychogenic cough. In patients who do not have signs or symptoms of an underlying respiratory system disease and do not respond to empiric therapy, psychogenic cough should be considered. We present patients aged between 5 and 12 years who were referred to the clinic for consultation with pulmonologist due to chronic cough. Physical examinations, laboratory tests, and functional studies (spirometry), did not identified any abnormalities. A therapy with magnesium oxide was administered for four weeks, and clinical improvement with a reduction in cough episodes was observed. The differential diagnosis of chronic cough in children should include tic disorders as well as psychogenic cough. Tic disorders can be diagnosed easily with detailed history, and their response to medical treatment is rather satisfactory. Recognition of these disorders by pediatricians will minimize erroneous diagnoses and inappropriate therapies in children with complaints of chronic cough.
Key words: chronic cough, psychogenic cough, tics, pediatric age
Address for correspondence: Elena Stoeva, MD, е-mail: elena.rumenova91@gmail.com