Una tosse “ticcosa”

This case report describes a healthy 6-year-old girl who developed a diurnal, dry, repetitive and stereotyped tic (psychogenic) cough that began after a hospitalisation abroad perceived by the family as traumatic. The cough was frequent during the day, absent during sleep, increased when the child was asked to suppress it, and was accompanied by a polite hand-to-mouth gesture. Organic causes were systematically excluded through negative prick tests, ENT evaluation and laryngoscopy, and multiple pharmacological trials with antitussives, mucolytics, bronchodilators and corticosteroids proved ineffective. Rather than dismissing the symptom, the clinicians proposed a psychotherapeutic approach combined with EMDR (Eye Movement Desensitization and Reprocessing). Through sessions involving the parents and then the child individually, and by reprocessing the memory of the hospitalisation, the symptom resolved completely, with the family reporting no further episodes months later. The case underlines the value of recognising the typical features of tic cough and of addressing its psychogenic and post-traumatic basis with psychotherapy and EMDR.

Il caso descrive una bambina sana di sei anni e mezzo che ha sviluppato una tosse ticcosa (psicogena): secca, stizzosa, ripetitiva, stereotipata, presente durante il giorno e assente nel sonno, comparsa e ingravescente dopo un ricovero all'estero vissuto come traumatico. La tosse aumentava quando le si chiedeva di smetterla ed era accompagnata dal gesto di portare educatamente la mano alla bocca. Escluse le cause organiche (prick test, visita ORL e laringoscopia negativi) e risultati inefficaci i numerosi tentativi con sciroppi antitosse, mucolitici, salbutamolo e cortisonici, e stato proposto un percorso psicoterapico associato all'EMDR (Eye Movement Desensitization and Reprocessing). Attraverso il coinvolgimento dei genitori e poi sedute individuali, con l'elaborazione del ricordo del ricovero, il sintomo si e risolto stabilmente. Il caso ricorda l'importanza di riconoscere le caratteristiche tipiche della tosse ticcosa e di non minimizzarla, considerando la psicoterapia e l'EMDR come opzione efficace nei sintomi a base psicogena e post-traumatica.