Abstract
Intractable sneezing is rare and may not be familiar to many physicians. A 10-year-old girl had a mild viral illness that culminated in uncontrollable sneezing without any other symptoms. She sneezed with her eyes either opened or closed, and her sleep usually was not interrupted by sneezing. Routine physical and rhinoscopic examination as well as laboratory investigations were normal. Multiple oral and topical medications were ineffective in providing long-term relief from sneezing. The patient had no obvious school or home problems, but evaluation by a child psychiatrist revealed significant internal conflicts. Educationally, she was a "gifted child," yet she displayed infantile behavior, manifested by her continued sleeping with her parents. Family psychotherapy was recommended. Common features of psychogenic intractable sneezing are presence in an adolescent female, sneezing with eyes open, quiescence during sleep, nonresponse to medical therapy, normal physical examination, lack of related symptomatology, underlying psychologic stress, and good response to psychiatric techniques. Early consideration of a psychogenic origin and prompt psychiatric intervention for intractable sneezing may forestall exhaustive diagnostics and result in complete symptom resolution.
Published Version
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