Short report
Chronic cough in the Holmes-Adie syndrome: association in five
cases with autonomic dysfunction
a Neurovascular Medicine Unit, Division of Neuroscience
and Psychological Medicine, Imperial College School of Medicine, and
Autonomic Unit, University Department of Clinical Neurology, National
Hospital for Neurology and Neurosurgery, Queen Square, Institute of
Neurology, University College London, UK, b Chest and Allergy Unit, Department of Medicine, St
Mary's Hospital, London
Correspondence to: Dr J Kimber, Neurovascular Medicine Unit, Division of Neuroscience and Psychological Medicine, Imperial College School Of Medicine, St Mary's Hospital, Clarence Wing, Praed Street, London W2 1NY, UK. Telephone 0044 171 886 1468; fax 0171 886 1540.
Received 23 September 1997 and in revised form 4 March 1998;
Accepted 9 March 1998
The Holmes-Adie syndrome consists of unilateral or bilateral
tonic pupils with near light dissociation and tendon areflexia. It is
associated with autonomic disturbances affecting sudomotor and
vasomotor function. Five such patients are reported on who also had a
troublesome chronic dry cough, which was of unknown aetiology and was
resistant to a range of treatments. The cough may be related to
involvement of afferent or efferent pathways in the vagus. Chronic
cough may be an accompaniment in the Holmes-Adie syndrome, like other
forms of autonomic dysfunction.
© 1998 by Journal of Neurology, Neurosurgery, and Psychiatry
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