Abstract
The sneezing reflex is a common phenomenon in human beings and animals. Until now largely uninvestigated sneezing phenomenon is the photic sneeze reflex, also known as the ACHOO (Autosomal Cholinergic Helio-Ophtalmologic Outburst). This light induced sneezing reflex is triggered by a bright light like the sun but also by artificial light. In former publications the prevalence of this phenomenon in the population is specified up to 35 % and can result in a potential endangerment in numerous everyday situations as driving a car or controlling an airplane. In our present study we interviewed 1042 patients in the Department of Otorhinolaryngology of the Saarland University Hospital using standardized questionnaires to analyse epidemiological data as age, gender and known diseases. Additionally, the questionnaire focused on the occurrence of sneezing events, extend of sneezing, potential triggers, and methods of evasion. In our data analysis, we were able to show a high prevalence of the ACHOO in 57 % of our cohort, suffering from regular light induced sneezing events. Excluding subjects reporting only occasional sneezing events our results were comparable to findings in literature. As expected a familial disposition was observed, additionally tobacco smoking correlated with light induced sneezing events. Analyzing a large cohort, we were able to demonstrate that the prevalence of the ACHOO in the german population may be higher than expected. Taken into account the potential hazard caused by this phenomenon, further investigations should identify the pathophysiologic pathway.
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References
Baydin A, Nural MS, Güven H, Deniz T, Bildik F, Karaduman A (2005) Acute aortic dissection provoked by sneeze: a case report. Emerg Med J 22(10):756–757
Beckman L, Nordenson I (1983) Individual differences with respect to thesneezing reflex: an inherited physiological trait in man? Hum Hered 33:390–391
Benbow EW (1991) Practical hazards of photic sneezing. Br J Ophthalmol 75:447
Birkent H, Durmaz A, Hidir Y, Erdem U, Tosun F (2008) Sneezing-related orbital emphysema and pneumocephalus treated with transnasal endoscopic surgery. J Otolaryngol Head Neck Surg 37(6):E167–E169
Breitenbach RA, Swisher PK, Kim MK, Patel BS (1993) The photic sneeze reflex as a risk factor to combat pilots. Mil Med 158(12):806–809
Collie WR, Pagon RA, Hall JG, Shokeir MHK (1978) ACHOO syndrome (autosomal dominant compelling helio-ophtalmic outburst syndrome). Birth Defects XIV 6B:361–363
Everett HC (1964) Sneezing in response to light. Neurology 14:483–490
Fink JN (2001) Localisation of the sneeze center. Neurology 56(1):138
Fonseca AC, Ferreira JJ, Albuquerque L, Ferro JM (2007) Sneeze as a precipitating factor of cerebral venous thrombosis. Eur J Neurol 14(10):e7–e8
Gwaltney JM Jr, Hendley JO, Phillips CD, Bass CR, Mygind N, Winther B (2000) Nose blowing propels nasal fluid into the paranasal sinuses. Clin Infect Dis 30(2):387–391
Lang DM, Howland WC (1987) Solar sneeze reflex. J Am Med Assoc 257:1330–1331
Langer N, Beeli G, Jäncke L (2010) When the sun prickles your nose: an EEG study identifying neural bases of photic sneezing. PLoS One 5(2):e9208. doi:10.1371/journal.pone.0009208
Morris HH 3rd (1987) ACHOO syndrome: prevalence and inheritance. Clev Clin J Med 54:431–433
Nishino T (2000) Physiological and pathophysiological implications of upper airway reflexes in humans. Jpn J Physiol 50(1):3–14
Peroutka SJ, Peroutka LA (1984) Autosomal dominant transmission of the photic sneeze reflex. N Engl J Med 310:599–600
Sedan J (1954) Photosternutatory reflex. Rev Otoneuroophtalmol 26:123–126
Seijo-Martinez M, Varela-Freijanes A, Grandes J et al (2006) Sneeze related area in the medulla: localisation of the human sneezing centre? J Neurol Neurosurg Psychiatry 77:559–561
Semes LP, Amos JF, Waterbor JW (1995) The photic sneeze response: a descriptive report of a clinic population. J Am Optom Assoc 66(6):372–377
Songu M, Cingi C (2009) Sneeze reflex: facts and fiction. Ther Adv Respir Dis. 3(3):131–141
Suranyi L (2001) Localization of the “sneeze center”. Neurology 57(1):161
Wallois F, Macron JM, Jounieaux V, Duron B (1991) Trigeminal afferences implied in the triggering or inhibition of sneezing in cats. Neurosci Lett 122(2):145–147
Whitehead E (1999) Sudden sensorineural hearing loss with fracture of the stapes footplate following sneezing and parturition. Clin Otolaryngol Allied Sci 24(5):462–464
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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Kulas, P., Hecker, D., Schick, B. et al. Investigations on the prevalence of the photo-induced sneezing reflex in the German population, a representative cross-sectional study. Eur Arch Otorhinolaryngol 274, 1721–1725 (2017). https://doi.org/10.1007/s00405-016-4256-2
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DOI: https://doi.org/10.1007/s00405-016-4256-2