Wiener D, McGrath K, Patterson R
J Allergy Clin Immunol. 1985 Jun;75(6):741-2. doi: 10.1016/0091-6749(85)90104-6.
We report a case of hysterical, intractable paroxysmal sneezing in an adolescent girl. The patient had been observed by two pediatricians, an allergist, an emergency room physician, and a chiropractor. She had been treated with antihistamines, epinephrine, corticosteroid nasal spray, and a 1-week course of an oral corticosteroid without improvement. She was referred for evaluation of an allergic etiology before continuing her workup with a computed tomographic head scan. The patient had been sneezing almost daily for 3 mo up to 2000 times a day. The patient did not sneeze at night. She had nasal congestion but no rhinorrhea or eye symptoms. She did not sneeze during the interview. The results of a physical examination were normal except for mild obesity. No organic cause was found. Most cases of intractable paroxysmal sneezing reported in the literature occur in adolescents and appear to have a psychogenic etiology. The problem was discussed with the child and parents, and psychologic therapy was recommended. Considerable decrease in sneezing subsequently occurred, but the parents credited this is further chiropractic therapy.
我们报告一例青春期女孩癔症性、顽固性阵发性喷嚏的病例。该患者曾由两名儿科医生、一名过敏症专科医生、一名急诊室医生和一名脊椎按摩师诊治。她接受过抗组胺药、肾上腺素、皮质类固醇鼻喷雾剂治疗，以及为期1周的口服皮质类固醇治疗，但均无改善。在继续进行头部计算机断层扫描检查之前，她被转诊以评估是否存在过敏性病因。患者几乎每天打喷嚏3个月，每天多达2000次。患者夜间不打喷嚏。她有鼻塞，但无流涕或眼部症状。在问诊期间她不打喷嚏。体格检查结果除轻度肥胖外均正常。未发现器质性病因。文献中报道的大多数顽固性阵发性喷嚏病例发生在青少年中，且似乎有心理病因。与患儿及其父母讨论了该问题，并建议进行心理治疗。随后喷嚏次数大幅减少，但父母认为这归功于进一步的脊椎按摩治疗。
