Complex partial seizures: Going out with a hiccup

Alix, James J P; Ponnusamy, Athi; Bhattacharyya, Dipak Kumar; Hoggard, Nigel; Grünewald, Richard A.

doi:10.1016/j.seizure.2012.09.001

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…EEG showed frontal spikes only, and after eight days his hiccups spontaneously terminated and his seizures promptly returned (Ikeda et al, 2001). In support of this suggestion, the 23-year-old patient described by Alix et al (2012) had significantly improved seizure control with insertion of a vagal nerve stimulator. This inhibitory aspect of hiccups does not seem to apply in all cases however, most notably in the Hahn and Neubauer (2012) case report where the hiccups were an early and predominant semiological feature.…”

Section: Discussionmentioning

confidence: 72%

“…Alix et al . reported two adults with hiccups as part of their seizure semiology (Alix et al ., ). The first was a 73‐year‐old female with right mesial temporal sclerosis and semiology characterised by right hand automatisms, head version, left hand clonus and finally hiccups, which eventually lead to seizure termination.…”

Section: Discussionmentioning

confidence: 97%

“…A further group reported a 6-year-old with hiccups as a predominant symptom of her juvenile myoclonic epilepsy, with EMG spikes closely correlating with EEG discharge and diaphragmatic myoclonus, but, exceptionally, no other forms of limb myoclonus (Hahn and Neubauer, 2012). Alix et al reported two adults with hiccups as part of their seizure semiology (Alix et al, 2012). The first was a 73-year-old female with right mesial temporal sclerosis and semiology characterised by right hand automatisms, head version, left hand clonus and finally hiccups, which eventually lead to seizure termination.…”

Section: Discussionmentioning

confidence: 99%

“…Hiccups have been rarely described as a manifestation of focal epilepsy (Lin et al ., ; Ponnusamy et al ., ; Alix et al ., ; Hahn and Neubauer, ). We report an unusual seizure semiology, including hiccup‐like episodes, in a patient with an extremely rare genetic condition, trisomy 4p.…”

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confidence: 99%

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Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition

Varley

Wehner

Sisodiya

2015

Epileptic Disorders

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In this report, we describe a female patient with trisomy 4p, a rare genetic condition, with unusual seizure semiology. The patient is one of the oldest reported survivors with this condition. This semiology was noted while she was being monitored by inpatient video telemetry. We observed a series of myoclonic shoulder jerks, followed by hiccup‐like episodes, and finally an atonic head drop. Corresponding ictal EEG showed semi‐rhythmic high‐amplitude slow waves with spikes superimposed over the frontotemporal areas. This semiology was confirmed as habitual by her parents. Subsequent hiccup‐like episodes had no EEG correlate, and the head drop was again associated with semi‐rhythmic high‐amplitude slow waves and superimposed spikes, more prominent over the right hemisphere. In addition, we review the several cases in which hiccups have been associated with seizures and how this may relate to the neural pathways involved in the pathophysiology of hiccups. We believe the ictal hiccup‐like episodes followed by atonia to be a seizure semiology that has not previously been documented. [Published with video sequence]

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition

Varley

Wehner

Sisodiya

2015

Epileptic Disorders

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“…Der Schluckauf wird allgemein als reflektorischer Bewegungsablauf gesehen, auch wenn ähnliche Phänomene iktal beobachtet wurden [2], [3]. Aus den resultierenden Muskelkontraktionen lassen sich dabei als Komponenten des efferenten Schenkels der N. phrenicus und der N. vagus (vor allem N. laryngeus recurrens) sowie die Nn.…”

Section: Physiologie Des Schluckaufsunclassified

Singultus – Diagnostik und Therapie

Ohlrich¹,

Royl²

2017

Laryngo-Rhino-Otol

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A hiccup is a reflex movement with diffusely distributed afferents and efferents in the thorax; its functional relevance is controversial. In its physiological form, it is mostly a minor complaint that stops spontaneously and rarely leads to medical consultation. However, prolonged agonizing hiccups represent serious deterioration of quality of life. Chronic hiccups by definition last for more than 48 h, with gastroesophageal reflux being the frequent underlying disease. Various other causes affect multiple organ systems, some with serious underlying diseases. A hiccup may be the only symptom at the first manifestation of some neurological disorders. In neuroimaging a lesion of the medulla oblongata is often seen. A NMO and an ischemic stroke with Wallenberg syndrome are 2 frequently underlying neurological diseases, but other inflammatory and vascular diseases and tumors of the central nervous system may be present. No optimal evidencebased recommendations for diagnosis and management of chronic hiccups are available. The search for the underlying disease often requires an interdisciplinary approach by internists, neurologists, and otolaryngologists. Symptomatic treatment may be necessary even before diagnosis. Persistent hiccups, a common problem in oncological palliative care, are often challenging. Proton pump inhibitor or prokinetics are used for treating underlying gastroesophageal reflux and baclofen with or without gabapentin in other cases. Anticonvulsants, antipsychotics, antidepressants, and calcium channel blockers represent other alternative treatment possibilities. In therapy-refractory cases, invasive procedures such as the selective phrenic nerve block are available. More studies are needed to help deal with the diagnostic and therapeutic challenge that hiccups present for neurologists.

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Hiccups in neurocritical care

et al. 2021

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Hiccup or hiccough is known by the medical term "singultus," which is a derivative of the Latin word "singult, " meaning "a gasp" or "a sob" [1]. Hiccups are characterized by involuntary, intermittent, repetitive, myoclonic, and spasmodic contractions of the diaphragm and the inspiratory intercostal muscles, leading to an abrupt and early closure of the glottis, terminating inspiration and generating the characteristic "hic" sound [2,3]. Both healthy adults and children commonly experience hiccup spells. In the fetus, hiccups play a physiological role by training the respiratory muscles for their breathing function, and as a reflex preventing amniotic fluid aspiration [4,5]. Transient episodes usually do not

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Complex partial seizures: Going out with a hiccup

Cited by 5 publications

References 8 publications

Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition

Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition

Singultus – Diagnostik und Therapie

Hiccups in neurocritical care

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