Cough-anal reflex:
Anal wink in response to cough or sniff is an important clinical sign on neurologic examination. It can be elicited by asking the patient to voluntarily cough or sniffle while observing the anus. This reflex is not affected by transection of the spinal cord, whereas it is lost in cauda equina lesions. It is easier to perform and more comfortable for the patient than the classic anal reflex. It is very promising and should be better included in the neurological examination (64).
Conclusion:
Cough is an important neurological sign, as well as an important respiratory sign. The sensitivity of the cough reflex may be increased or decreased in many neurologic conditions. Cough reflex testing is a quick, easy, and inexpensive test that can be performed during the cranial nerve exam.
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