Malignant Cough Syncope from Idiopathic Vagal Inflammation

We describe the case of a patient with malignant vasodepressive cough syncope. We demonstrated a vaso-vagal mechanism related to left vagal neuritis, by means of laryngoscopy and laryngeal electromyography. The condition resolved with steroid therapy. LEARNING POINTS: Left vagal neuritis should be considered in the differential diagnosis of recent onset repetitive loss of consciousness, in particular if cough related. Steroids were used to successfully treat recent onset cough-related syncope. Relatively simple trials of drug therapy can sometimes avoid intensive investigations; in our case, the use of a systemic steroid would probably have avoided many radiological and endoscopic examinations.