Department of Neurology

Cough-induced seizures

Q: My dad was diagnosed with inoperable lung cancer several months ago. He has coughing spells that get so severe that he has seizures. He will be out for maybe 30 seconds and he wakes up. No post-ictal stage at all. The doctors say it's due to a lack of oxygen when he coughs so severely. Is there any treatment for this condition? He's starting to have a lot of them, so any help you can offer would be appreciated. Thanks, Kenny.

A: Although your father may have epileptic seizures, there is also an entity called "tussive syncope" that your father may have. This is a drop in blood pressure caused by uncontrolled coughing. The coughing can trigger certain reflexes that drop the blood pressure. During tussive syncope, a seizure may result from the drop in blood pressure, rather than being caused by electrical abnormalities of the brain. In this situation, one approach to treatment would be to give anti-tussive (anti-cough) therapies. Some examples would be dextromethorphan (found in some cough syrups) or codeine. Whether your father has tussive syncope would need to be determined by your neurologist, and I recommend you seek a neurologic evaluation.

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