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Question 14: Hi Dunc: What do you know about the Asthsma/ coughing tic? [My son] has had a horrible cough for the last week, was dx with asthsma long before TS but am hearing things about it as a tic now. Matt has no weezing currently (at the moment) but is constantly coughing and the inhaler doesnt work. I know you're busy so I'll understand if you can't respond and won't be upset. R.S., MO, USA

Hi R.S.:

I know that the 'establishment' knows about this tic -- the following are some references available:

Eisenberg, J, Wahrman, O & Bamberger, E: Greenberg, D. (1997). Psychogenic cough tic: a case report. Isr(ael?) Journal of Psychiatry and Related Sci(ences?), 34(3), 235-238.

Hogan, MB & Wilson, NW. (1999). Tourette's syndrome mimicking asthma. Journal of Asthma, 36(3), 253-256.

Plaza, V. (1999). Chronic persistent cough due to Gilles de la Tourette's syndrome. Respiration, 66(4), 380

Wagaman, JR, Miltenberger, RG & Williams, DE. (1995). Treatment of a vocal tic by differential reinforcement. Journal of Behavioural Therapy (and?) Experimental Psychiatry, 26(1), 35-39.

 

In general any literature seems to say 'yes it exists' and 'be sure it is really TS' -- sometimes it might be asthma or a condition known as Psychogenic Cough Tic.

Obviously in your son's case diagnoses of both asthma and TS have been made, and so it is quite possible that the TS has grabbed hold of and 'amplified' the asthma symptoms (particularly if you are finding that the 'asthma symptoms' are not responding to asthma treatments). Tics form out of frequent and stereotypical movements and sounds (things you do or utter often, and the same way each time) -- obviously with a history of asthma coughing and wheezing would both be prime targets for a neurology browsing around looking for something new to do.

This is similar to something I mentioned in my response to Question 4 -- I discuss how attention to a particular behaviour (in that case unusual eye movements) can cause that behaviour to either become enshrined in a tic or to increase the frequency of an existing tic.

The fourth reference I supplied was a report of a successful case of using reinforcement to eliminate a throat clearing/coughing tic when Habit Reversal Training (HRT) was not a technique preferred by the client. If this particular tic becomes very worrisome or disruptive to your son, HRT (or what's now known as the Comprehensive Behavioural Intervention for Tics / CBIT) has considerably more, and more rigorous, evidence to support it's high effectiveness. To learn more about HRT and/or CBIT take a look at my book Nix Your Tics! Eliminate Unwanted Tic Symptoms: A How-To Guide For Young People.

Hope this helps R.S!

Dr. Dunc.

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