Journal article
Vagus Associated Neurogenic Cough Occurring Due to Unilateral Vascular Encroachment of Its Root: A Case Report and Proof of Concept of VANCOUVER Syndrome
Annals of otology, rhinology & laryngology, v 129(5), pp 523-527
01 May 2020
PMID: 31786948
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: A patient is presented with neurogenic cough due to a unilateral vascular compression of a vagus nerve rootlet at the brainstem with complete resolution of cough following microvascular decompression of that nerve. This etiology of a neurogenic cough has not been previously reported to our knowledge. The proportion of patients with neurogenic cough refractory to all current therapies and suffering with this treatable condition remains to be defined. We introduce the concept of Vagus Associated Neurogenic Cough Occurring due to Unilateral Vascular Encroachment of its Root (VANCOUVER syndrome) and present the salient features of this condition. Methods: A case review is presented with details of the patient's history, examination, imaging, laryngoscopy, intraoperative findings, and long-term clinical outcome. Results: A 60-year-old man presented with a 15-year history of non-productive cough refractory to antibiotics, and anti-reflux medications. Investigations by an allergist, a cardiologist, a gastroenterologist, two pulmonologists, and an otolaryngologist were negative. MRI demonstrated a vascular compression of his left vagus nerve and microvascular decompression of that nerve resolved his symptoms. There were no surgical complications and the patient remains asymptomatic at 1 year. Conclusions: Neurogenic cough has been likened to a vagus nerve neuropathy in a similar way that trigeminal neuralgia is a trigeminal nerve neuropathy. Both cause intermittent sensory phenomena in their distribution and can be ameliorated with neuropathic medications. We demonstrate that neurogenic cough, like trigeminal neuralgia, may be caused by a vascular compression of its nerve root. A proposed mechanism of this type of neurogenic cough is presented along with a potential diagnostic paradigm for these patients.
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Details
- Title
- Vagus Associated Neurogenic Cough Occurring Due to Unilateral Vascular Encroachment of Its Root: A Case Report and Proof of Concept of VANCOUVER Syndrome
- Creators
- Christopher R. Honey - University of British ColumbiaMarie T. Kruger - University of British ColumbiaMurray D. Morrison - University of British ColumbiaBaljinder S. Dhaliwal - University of British ColumbiaAmanda Hu - University of British Columbia
- Publication Details
- Annals of otology, rhinology & laryngology, v 129(5), pp 523-527
- Publisher
- Sage
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Otolaryngology (and Head and Neck Surgery)
- Web of Science ID
- WOS:000500130300001
- Scopus ID
- 2-s2.0-85077373476
- Other Identifier
- 991019298815804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Otorhinolaryngology