Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

Kang, Keum Nae; Park, In Kyung; Suh, Jeong Hun; Leem, Jeong Gill; Shin, Jin Woo

doi:10.3344/kjp.2010.23.3.198

Cited by 32 publications

(29 citation statements)

References 17 publications

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“…Pulsed radiofrequency treatment is a safe, minimally invasive and non‐destructive treatment procedure that has been increasingly used for treatment of some chronic pain conditions. Pulsed radiofrequency treatment is the procedure of choice for critically ill patients as well as patients who do not prefer surgical treatment …”

Section: Discussionsupporting

confidence: 93%

3D CT‐Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia

et al. 2013

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Trigeminal neuralgia (TN) is a pain syndrome characterized by pain in the trigeminal area often accompanied by a brief facial spasm or tic. The purpose of our study was to investigate the efficacy and clinical utility of CT-guided pulsed radiofrequency (PRF) for treatment of TN. Patients who were diagnosed with severe TN between September 2010 and October 2010 at Beijing Tiantan Hospital were included. Pulsed radiofrequency treatment (PRFT) was employed to treat TN. To verify the accurate needle position, a thin-section cranial CT scan was performed by using a multidetector CT scanner. Three-dimensional reconstruction was performed to visualize the location of the needle and the foramen ovale. A total of 20 patients were included in the study. Seven patients (35%) had favorable outcome 1 year after the PRFT. The numeric rating scale in the 7 patients with good outcome was significantly lower than the 13 patients with bad outcome at 1 day, 1 week, and 2 weeks after the treatment. The remaining 13 patients had residual pain 2 weeks after the PRFT and had to receive radiofrequency thermocoagulation (RFTC). In conclusion, the results of our study demonstrate that CT-guided PRFT is not an effective method of pain treatment for idiopathic TN as compared with conventional RFTC. However, CT-guided PRFT is associated with less complication than RFTC.

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Section: Discussionsupporting

confidence: 93%

3D CT‐Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia

et al. 2013

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“…Even a left vagal afferent blockade via nerve stimulation might be applied to stroke related intractable hiccup after failure of phrenic nerve block 69. Ultrasound guided pulsed radiofrequency ablation of phrenic nerve was another option to treat coronary by-pass surgery related hiccup 70. Acupuncture has been employed to treat serious hiccups among patients with myocardial infarction and metastatic liver tumor 30,71.…”

Section: Etiology Of Persistent and Intractable Hiccupsmentioning

confidence: 99%

Hiccup: Mystery, Nature and Treatment

Chang¹,

2012

J Neurogastroenterol Motil

161

173

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Hiccup is the sudden onset of erratic diaphragmatic and intercostal muscle contraction and immediately followed by laryngeal closure. The abrupt air rush into lungs elicits a "hic" sound. Hiccup is usually a self-limited disorder; however, when it is prolonged beyond 48 hours, it is considered persistent whereas episodes longer than 2 months are called intractable. A reflex arc involving peripheral phrenic, vagal and sympathetic pathways and central midbrain modulation is likely responsible for hiccup. Accordingly, any irritant in terms of physical/chemical factors, inflammation, neoplasia invading the arc leads to hiccups. The central causes of hiccup include stroke, space occupying lesions and injury etc, whereas peripheral causes include lesions along the arc such as tumors, myocardial ischemia, herpes infection, gastroesophageal reflux disease and applied instrumentations on human body etc. Besides, various drugs (eg, anti-parkinsonism drugs, anesthetic agents, steroids and chemotherapies etc) are the possible etiology. An effective treatment of persistent hiccup may be established upon the correct diagnosis of lesion responsible for the serious event. The pharmacotherapy of hiccup includes chlorpromazine, gabapentin, baclofen, serotonergic agonists, prokinetics and lidocaine. Non-pharmacological approaches such as nerve blockade, pacing, acupuncture and measures to hold breathing are also successful. Finally, alternative medicines and remedies are convenient to treat hiccups with uncertain effect. In conclusions, hiccup is likely to result from lesions involving the hiccup reflex arc. The lesion may need to be localized correctly for ablative treatment in patients with intractable hiccup. Apart from lesion ablation, drugs acting on reflex arc may be effective, while some other conventional measures may also be tried.

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“…Son yıllarda baklofen ve gabapentin monoterapi veya kombinasyon olarak kullanılmaktadır (6). Olgu 1'de on yıldır devam eden hıçkırık vardı ve çoklu ilaç tedavisi uygulanmış, şikayetleri azalmış ancak tamamen geçmemiştir.…”

Section: Discussionunclassified

“…Kang ve ark. son dönem böbrek yetmezlikte ve medikal tedaviye cevap vermeyen hıçkırıkta sağ ve sol sinir bloğunu takiben bilateral 2 dk pulse RF uyguladıkları, şikayetleri azalan ama geçmeyen hastaya iki ve dört ay sonra aynı prosedürü tekrarlamış ve kalıcı tedavi sağlamışlardır (6).Bizim vakalarımızda frenik sinir blokajını takiben 10 dk süre ile pulse RF uygulamasını tekrarlamaya gerek duyulmadan hastaların şikayetleri azalarak geçti.…”

Section: Discussionunclassified

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Direncli Hickirik Tedavisinde Frenik Sinire Pulse Radyofrekans Uygulamasi

2015

GMJ

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ÖZETHıçkırığın yüzden fazla nedeni vardır. Hıçkırık günler, haftalar, hatta aylarca devam edebilir. Dirençli veya persistan hıçkırık; depresyon, yorgunluk, bozulmuş uyku düzeni, dehidratasyon, malnütrisyon ve aspirasyona yol açabilir. Hıçkırık non-invaziv veya farmakolojik ajanlarla tedavi edilebilir. Eğer bu yöntemler başarısız olursa frenik sinir blokajı veya cerrahi tedaviler uygulanabilir. Biz, bu yazıda persistan ve dirençli hıçkırığı olan, konservatif tedaviye yanıt vermeyen fakat sinir stimülatörü eşliğinde uygulanan frenik sinir blokajı ile geçici etki elde edilen ve takibinde frenik sinire uygulanan pulse radyo frekans (pulse RF) sonrasında hıçkırığı geçen56 ve 52 yaşlarında iki olguyu sunduk.Anahtar Sözcükler: Hıçkırık, frenik sinir blokajı, pulse radyofrekans ABSTRACTThere are more than hundred reasons of hiccups and they can last as long as days, weeks or even months. Persistent hiccups can cause depression, fatigue, altered sleeping pattern, dehydration, malnutrition and aspiration. Hiccups can be treated using non-invasive or pharmacological agents. Should these methods fail; phrenic nerve block or surgical procedures can be used. In this paper, we have presented two cases that involve patients of age 56 and 52, with persistent and intractable hiccups irresponsive to conservative treatment, whose hiccups was treated by phrenic nerve block using nerve simulator temporarily, followed-up by pulsed radiofrequency applied on phrenic nerve.

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Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

Cited by 32 publications

References 17 publications

3D CT‐Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia

3D CT‐Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia

Hiccup: Mystery, Nature and Treatment

Direncli Hickirik Tedavisinde Frenik Sinire Pulse Radyofrekans Uygulamasi

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