REFERENCE · DIAGNOSTIC TECHNIQUES

Cough and Upper-Airway Diagnostic Inventory

All seven original descriptions and source associations are preserved below. These include observations, criteria and differential investigations, not seven validated FND tests.

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Clinical Cough Assessment · Tic and Somatic Cough Assessment · Laryngoscopy and Upper-Airway Assessment

Diagnostic techniques at a glance

Tic-cough assessment

The clinician considers suppressibility, distractibility, suggestibility, variability and any preceding urge after appropriate cough assessment. CHEST recommendations use a tic framework, supported by low-quality evidence. These features do not automatically classify every cough as an FND symptom. [2]

Somatic cough syndrome criteria

This formulation requires a comprehensive medical assessment and applicable somatic-symptom criteria. It is distinct from tic cough and cannot be diagnosed merely because tests are normal. The guideline found no validated diagnostic criteria for the older cough labels. [2]

Cough sound and sleep pattern

A barking or honking quality and absence during sleep have been historically emphasized. CHEST advises against using these to diagnose or exclude the syndrome. They are history observations, not reliable positive signs. [2]

Task and attention comparisons

Changes during conversation, breathing or another appropriate activity can characterize the cough. They may inform specialist assessment but lack standalone FND accuracy evidence. Avoid repetitive provocation, especially when discussion itself triggers symptoms. [1][2]

Laryngoscopy during typical airway symptoms

Visualization can document inducible laryngeal narrowing. Normal examination between episodes may miss it. This supports inducible laryngeal obstruction when the pattern matches; it does not by itself establish a neurological FND diagnosis. [3]

Continuous laryngoscopy during exercise

For exertional symptoms, a specialist may observe the larynx through a monitored exercise challenge. The test addresses exercise-induced laryngeal obstruction, not FND in general. Suitability and safety determine whether provocation is justified. [3]

Respiratory and other differential testing

History, examination and selected investigations assess asthma, infection, reflux, medication effects and other causes. These tests answer specific differential questions; normal results do not positively diagnose functional cough or airway symptoms. [2][3]

Research and Sources

Inherited descriptions retain their original local source numbers. The detailed guides distinguish adult respiratory guidance, tic/somatic criteria and ILO evidence.

Citation	Full citation
[1]	Baker J, Barnett C, Cavalli L, et al. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. Journal of Neurology, Neurosurgery & Psychiatry. 2021;92(10):1112–1125. FND-CIT-0025. https://doi.org/10.1136/jnnp-2021-326767
[2]	Vertigan AE, Murad MH, Pringsheim T, et al. Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children: CHEST Guideline and Expert Panel Report. Chest. 2015;148(1):24-31. DOI. PMID: 25856777. FND-CIT-0129.
[3]	Haines J, Esposito K, Slinger C, et al. UK consensus statement on the diagnosis of inducible laryngeal obstruction in light of the COVID-19 pandemic. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 2020;50(12):1287-1293. DOI. PMID: 33034142. FND-CIT-0147.

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