Persistent hiccup as presenting symptom in medulla oblongata cavernoma: a case report and review of the literature

Giant PICA aneurysm presenting as intractable hiccups

“…The afferent path is made up of the vagus nerve, phrenic nerve, and sympathetic nerve chain arising from T6 to T12 and the efferent path of phrenic nerve and accessory respiratory muscles. 2,5,6 The connection between these pathways is believed to be in the brainstem. Multiple interactions between the brainstem and the midbrain are hypothesised to have a role in the genesis of hiccup, including the dorsal portion of the nucleus tractus solitarius, the ventral group of the nucleus ambiguous, phrenic nerve nuclei, medullary reticular formation and the hypothalamus.…”

Hiccups Attributable to Syringobulbia and/or Syringomyelia Associated with a Chiari I Malformation: Case Report

“…Experimental studies of electrical stimulation in the medulla oblongata of cats demonstrated that the site where the hiccup-like responses were generated was located in the medullary reticular formation lateral to the nucleus ambiguus, at the rostrocaudal level 1 to 2.5 mm rostral to the obex (3,18). Several reports in the literature address intractable hiccups attributable to lesions located in the medulla oblongata (1,4,11,14,16,22). Kumral and Acarer (11) described an unusual case of primary medullary hemorrhage in the right medial medullary region, with mild dorsal extension, that was associated with intractable hiccups.…”

“…Kumral and Acarer (11) described an unusual case of primary medullary hemorrhage in the right medial medullary region, with mild dorsal extension, that was associated with intractable hiccups. Musumeci et al (16) reported a case with persistent intractable hiccups as the presenting symptom of a cavernous angioma in the dorsal medullary region. There has been only one report describing a case of intractable hiccups associated with extensive syringomyelia and a Chiari malformation.…”

Intractable Hiccups Post Stroke: Case Report and Review of the Literature

“…IH are also seen in a variety of space occupying lesions including cavernous angiomas [10][11][12], haemangioblastomas [13], astrocytomas [14] and tuberculomas [15]. It is of note that IH can be the initial and often only presenting complaint in many of these patients.…”