TUSSIVE SYNCOPE

Abstract

IN 1876, Charcot¹ described the syndrome of laryngeal vertigo,² characterized by the loss of consciousness after severe coughing. Since then, occasional cases have been described, and in some instances the unusual vigor of coughing, associated with a respiratory infection, such as pertussis, may have been important. Whitty³ reviewed nearly 100 of these cases in 1943, adding 4 more, and stated that he felt that epilepsy was an important factor despite rather meager evidence. He quoted De Havilland Hall, who in 1894 called attention to the large number of middle-aged plethoric males with laryngitis or bronchitis in a series of these cases. Wilkins and Friedland⁴ observed that some normal subjects could lose consciousness by performing the Valsalva experiment of forced expiration against a closed glottis; in addition, diminished venous return and cardiac output were recorded by the ballistocardiographic method. The authors described 2 patients with pulmonary disease