Systemic review: the pathogenesis and pharmacological treatment of hiccups

Steger, M; Schneemann, Markus; Fox, Mark

doi:10.1111/apt.13374

Cited by 186 publications

(283 citation statements)

References 37 publications

(47 reference statements)

Supporting

Mentioning

205

Contrasting

Unclassified

Order By: Relevance

“…Physiological studies have demonstrated a mechanism by which these manoeuvres improve hiccups, with the frequency of hiccups decreasing as arterial PCO 2 rises. 6 In the case of persistent hiccups, the following drugs are used: haloperidol 2-5 mg/24 hr, metoclopramide 10 mg, baclofen 7 5 mg/8 hr, phenytoin, valproic acid, carbamazepine, gabapentin, amitriptyline, and amantadine. 8 Chlorpromazine 25-50 mg intramuscularly or intravenously is effective in up to 80% of cases.…”

Section: Managementmentioning

confidence: 99%

Hiccups: a common problem with some unusual causes and cures

Quiroga¹,

García

Guedes

2016

Br J Gen Pract

View full text Add to dashboard Cite

Section: Managementmentioning

confidence: 99%

Hiccups: a common problem with some unusual causes and cures

Quiroga¹,

García

Guedes

2016

Br J Gen Pract

View full text Add to dashboard Cite

“…1 We found no randomized controlled trials to compare the effectiveness of drug therapies for persistent or intractable hiccups; however, chlorpromazine has been effective in clinical practice and is the only medication approved by the US Food and Drug Administration for hiccups. Several alternative medications have been reportedly effective in the medical literature, including gabapentin.…”

Section: Go To Sectionmentioning

confidence: 99%

“…All are proposed to act on the GABAergic or dopaminergic neurons of the medulla. 1 The patient was admitted to the hospital neurology service and a course of chlorpromazine was administered. His hiccups, nausea, and vomiting resolved in less than 24 hours.…”

Section: Supplemental Data At Neurologyorgmentioning

confidence: 99%

Clinical Reasoning: A 46-year-old man with persistent hiccups, cognitive dysfunction, and imbalance

et al. 2017

View full text Add to dashboard Cite

A 46-year-old, right-handed, African American man presented to the emergency department after 1 week of persistent hiccups and 3 days of nausea and vomiting. His family member also noted that he had been experiencing right-hand tremor and gait imbalance for the last 3 months. Over the 6 months prior to presentation, the patient's coworkers had noticed that he was completing his work more slowly, that he was forgetting how to perform simple tasks, and that several times he had come to work at the wrong hours. The patient had a history of HIV diagnosed 10 years earlier and reported good adherence to an antiretroviral regimen consisting of tenofovir, emtricitabine, and atazanavir boosted by ritonavir, without any changes for several years. His viral load was undetectable when tested 8 months prior to presentation.The patient had experienced a 9-kg (20-lb) weight loss over the last 6 months and watery, nonbloody diarrhea for 3 days. He denied illicit or IV drug use, new sexual partners, recent travel, ill contacts, or toxic exposures.Neurologic examination revealed frequent hiccups; decreased short-term recall (1 of 5 words) after 5 minutes with normal registration; a 4-6 Hz, lowamplitude postural and action tremor of the right hand; appendicular ataxia of the upper limbs; and gait ataxia, especially prominent with tandem gait. The remainder of the physical examination was normal.Questions for consideration:1. Based upon the patient's history and neurologic examination, where do each of the patient's symptoms and signs localize? 2. Which are the most common neurologic causes of persistent or intractable hiccups? 3. What medications can be used for symptomatic treatments of persistent hiccups? GO TO SECTION 2From the The patient's history and examination revealed executive dysfunction localizing to the frontal lobe and decreased recall localizing to the temporal lobe, both signs of cognitive dysfunction. The tremor of the right hand could localize to the left basal ganglia, the spinocerebellar tracts, or the rubrocerebellothalamic projections (Holmes rubral tremor). With the addition of cerebellar findings such as appendicular ataxia localizing to the lateral cerebellum, and gait ataxia localizing to the midline cerebellum, a cerebellar tremor is favored. However, rubral and cerebellar tremors can be difficult to distinguish because they have similar frequency and are present with action and at rest. The varying localizations should indicate to the clinician that this disease process is either multifocal or diffuse, rather than the result of a single, focal lesion. Hiccups, also called singultus, are paroxysmal myoclonic activations of the diaphragm involving a reflex arc with afferent vagal input, central integration in the medulla area postrema, and efferent output via the phrenic nerves.1 Ischemia, encephalitis, neuromyelitis optica, 2 or neoplastic lesions affecting the medullary integrating center including the area postrema are the most common primary neurologic causes, although many other causes have been de...

show abstract

“…The center of the arc is thought to be located between cervical 3 and 5, whereas the efferent part consisted of phrenic nerve, accessory respiratory muscles, the glottis, and autonomic processes with medullary reticular formation and hypothalamus. However the exact pathophysiology is unclear 3,4 . The clinical manifestation may be transient and can be defined as hiccups lasting 48 hours or less, or persistent in cases of hiccups lasting longer than 48 hours, or intractable when it lasts more than a month.…”

Section: Introductionmentioning

confidence: 99%

Persistant hiccups due to the use of intravenous metilprednisolone in a patient wit relapsing remitting multiple sclerosis: a case report and literature review

Öztürk¹,

Değirmenci²,

Çamuşoğlu³

2016

Cumhuriyet Medical Journal

View full text Add to dashboard Cite

SUMMARYHiccups can be defined as the sudden, uncontrolled contractions of the diaphragm, followed by immediate inspiration and closure of the glottis over the trachea. Various etiologies are responsible for this reflex action such as instrumentations, gastrointestinal, cardiovascular, toxic-metabolic factors, and drugs. Most common drugs that may trigger hiccups are opioids, barbiturates, some antibiotics, chemotherapeutic agents, and steroids. Since steroids are one of the most common drugs in neurology practice, we here presented a patient with relapsing-remitting multiple sclerosis that experienced persistent hiccups after intravenous methyl-prednisolone treatment, to emphasize the side-effect of the drug. Keywords: Hiccups, intravenous methyl-prednisolone, side effect ÖZET Hıçkırık, trakenin üzerinden glottisin kapanması ve ani inspirasyon ile takip edilen, diyaframın ani ve kontrol edilemeyen kasılmaları olarak tanımlanabilir. Bu refleks eylemden enstrümentasyon, gastrointestinal, kardiyovasküler, toksik-metabolik faktörler ve ilaçlar gibi çeşitli etiyolojiler sorumludur. Hıçkırığı sıklıkla tetikleyen ilaçlar opiatlar, barbitüratlar, bazı antibiyotikler, kemoterapötik ajanlar ve steroidlerdir. Steroidler nöroloji pratiğinde en sık kullanılan ilaçlardan biri olduğundan, intravenöz metilprednizolon sonrası inatçı hıçkırık ortaya çıkan, atak ve iyileşmelerle giden bir multiple skleroz hastasını, ilacın yan etkisini vurgulamak amacıyla sunduk. Anahtar sözcükler: Hıçkırık, intravenöz metilprednizolon, yan etki CMJ Case Report

show abstract

Systemic review: the pathogenesis and pharmacological treatment of hiccups

Abstract: SUMMARY BackgroundHiccups are familiar to everyone, but remain poorly understood. Acute hiccups can often be terminated by physical manoeuvres. In contrast, persistent and intractable hiccups that continue for days or months are rare, but can be distressing and difficult to treat.

Cited by 186 publications

References 37 publications

Hiccups: a common problem with some unusual causes and cures

Hiccups: a common problem with some unusual causes and cures

Clinical Reasoning: A 46-year-old man with persistent hiccups, cognitive dysfunction, and imbalance

Persistant hiccups due to the use of intravenous metilprednisolone in a patient wit relapsing remitting multiple sclerosis: a case report and literature review

Contact Info

Product

Resources

About