Hello doctor, My father is 54 years old. He has a very heavy sneeze. When he sneezes he holds it back and he loses consciousness. I tell him not to hold it back but he is physically not able to let it go alone. Is there anything I can do to help him or anything he should do and are there any dangers in his life?
Hi. First, we need to find out what is the cause of recurrent sneezing. If you look into the physiology, sneeze is a protective reflex often in response to something irritative and offensive which the body wants to push out in order to prevent it from reaching the lungs and thereby into the circulation. Most commonly it is dust, but can be attributed to other irritative substances such as animal fur, pollens, smoke, fumes, etc. What can be done? 1. Prevention of entry of irritative substances is the key and plays a major role in preventing allergic responses. This can be effectively done by wearing an n95 mask most times even while indoors. 2. In addition, a combination of antihistaminic and steroidal spray containing Azelastine and Fluticasone two puffs two times a day does wonder. 3. Holding a sneeze inside can be lethal, as it is high pressure reflux and by holding the sneeze, reverse pressure can be created which has no where else to go but above to the cranium thereby an increase in intracranial pressure causing a vessel to rupture resulting in a stroke. This is a far possibility, but in elderly individuals, it can happen and is lethal. Secondly, an increase in intrathoracic pressure can also stimulate the vagus nerve resulting in vasovagal syncope causing a brief loss of consciousness. It is very important that these measures are followed in order to prevent any untoward incident. I hope this helps.