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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