@pamclark A few things stood out to me in your description on the cough syncope episode. In a cough, you are changing pressure in airways and blood circulation and the face turning read might indicate this too. Then the question is how does this increase in blood pressure affect the brain. With prior brain hemorrhages, these sites might be leaking blood through the vessels into the brain during the episode from an increase in blood pressure and actually causing a seizure. The hunching of the shoulders may be trying to expand the chest in panic breathing by using the neck muscles to pull the rib cage upward. I have asthma and I know that I unconsciously do that if I struggle to breathe. Syncope is a protective response to protect the brain if blood pressure gets to high. I had these episodes many times in my life from anxiety that raises my blood pressure, and only now in my adult life have I gotten control over this. Loss of oxygen to the brain causes a seizure like event that may not be an actual seizure. I passed out during painful nerve conduction tests with a neurologist and kicked my leg in what then called a myoclonic jerk. After that, I was sent for an MRI of the brain, and a sleep study.

The other questions you should ask would be if there is anything abnormal in the alignment of the head and neck that could impair circulation to the brain. There are some spine problems that can affect the circulation in vertebral artery and jugular veins. If there had been a prior injury to the neck, it may have left a physical problem that compromises the circulation a little bit all the time, but if provoked by a sudden change in blood pressure, it may have increased effects that could generate the syncope. A good physical therapist who rehabs spine surgery patients may be able to evaluate this, but only after they review current imaging on the spine and skull.

You also mentioned falling. Is this in relation to a syncope episode, or does this just happen? I'm not sure how old Michael is or if he has other physical traits that could lead to falls. I agree, you should come to Mayo and he should be evaluated. Have you had him evaluated for the reasons for his cough? I don't know if that is a reoccurring cough or just a random cough. There could be allergies or asthma involved.

Here are some links that may be of interest. They at least explain problems with similar symptoms and give you a basis to ask questions. I have thoracic outlet syndrome, and I am a spine surgery patient, and of course I have years of experience with syncope.

Sharing Mayo Clinic recently told my story, https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

(This one describes changes in circulation issues)
https://trainingandrehabilitation.com/vestibular-impairment-and-its-association-to-the-neck-and-tmj/
https://sharing.mayoclinic.org/2019/01/21/looking-to-crack-the-code-on-cavernous-malformations/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
Here is an abstract about Bow Hunter's Syndrome I found by searching on MayoClinic.org which explains how the blood supply is altered when the a patient turns their head and it has to do with artery compression due to spinal misalignment of the blood supply to the brain. If your vertebrae get stuck in a turned position, it can cause problems. It talks about vertigo, vision problems and tinnitus (ringing ears). That 's the link, and I pasted the text of the abstract below.
https://www.ncbi.nlm.nih.gov/pubmed/28062802?dopt=Abstract