Persistent hiccoughs as the predominant symptom with a tumour of the medulla oblongata

Vagus nerve stimulation for chronic intractable hiccups

“…The afferent pathways comprise the vagal, phrenic, and sympathetic (T6-12) branches. 2,8,11,16,17 Pharmacotherapy for intractable hiccups includes dopaminergic antagonists such as chlorpromazine and haloperidol; antiarrythmics such as nifedipine, lidocaine, and phenytoin; and other medicines such as metoclopramide, baclofen, and gabapentin. The central connection is a nonspecific area between the C3-5 spinal levels and the brainstem.…”

“…7,14,15 Effective surgical management may include phrenic nerve blockade or pacing. Two cases of cerebellar disease leading to hiccups have been reported; 8,16 however, the hiccups were medically intractable in both cases. In these cases, blockade of the phrenic nerve will not produce paralysis of the diaphragm.…”

Hiccups and Brainstem Compression

“…Intracranial lesions causing hiccups include multiple sclerosis [3], encephalitis [4], head injury [5], posterior fossa arteriovenous malformation [6], and tuberculoma of the medulla [7]. Stotka and coworkers [8] noted hiccups to be a manifestation of brainstem tumor, as did Kozik and Owsianowska [9]. Currier and coworkers [10] noted a close association between hiccups and pathological involvement of the ninth and tenth cranial nerve.…”

Intractable Hiccups as Presenting Symptom of Brainstem Tumor in Children

“…In adults, there have been reports of brainstem tumors presenting with intractable hiccups with a progressive course [2,5],…”