RESUMO
We present a patient with asneezia (inability to sneeze) of several years duration that was secondary to a progressive neurodegenerative disorder-progressive supranuclear palsy (PS). Asneezia can be seen in psychiatric conditions such as schizophrenia, depression and hypochondriasis. Organic etiology includes a neoplasm in the medulla located near the sneeze centre. In this patient the afferent pathway of sneeze reflex was intact. The urge to sneeze was present with intensification of intranasal discomfort, but eye closure and ability to expel air from the nostrils were absent. The aggerent and efferent pathways of the sneeze reflex pathways appeared intact on clinical testing. PSP pathologically consists of diffuse neurofibrillary change commonly involving the periaqueductal grey matter, pretectal region, subthalamic nucleus of Luys and pontomesencephalic tegmentum. Decrease in the inputs to the expiratory center in the medulla prevents the potentiation of a sneeze threshold and therefore produces asneezia. There were no cases to our knowledge of asneezia reported as a clinical manifestation of PSP. This condition can be quite distressing to the patient(AU)