Chronic cough in the Holmes-Adie syndrome: association in fivecases with autonomic dysfunction

The Holmes-Adie syndrome consists of unilateral or bilateraltonic pupils with near light dissociation and tendon areflexia. It isassociated with autonomic disturbances affecting sudomotor andvasomotor function. Five such patients are reported on who also had atroublesome chronic dry cough, which was of unknown aetiology and wasresistant to a range of treatments. The cough may be related toinvolvement of afferent or efferent pathways in the vagus. Chroniccough may be an accompaniment in the Holmes-Adie syndrome, like otherforms of autonomic dysfunction.