Intractable hiccups (Singultus) of psychogenic origin—A case report (original) (raw)
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Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol
Annals of general psychiatry, 2015
Hiccups or singulata are rhythmic involuntary movements of the diaphragm, caused by a variety of conditions that interfere with the functions of the nerve nuclei in the medulla and supra-spinal hiccup center. Although neurotransmitters and receptors involved in the pathophysiology of hiccups are not defined well, dopamine has been considered to play an important role. In some cases, chlorpromazine or other antipsychotics are used for the treatment of intractable hiccups but their efficacy is often limited. This report involves an 18-year-old patient who experienced two episodes of intractable hiccups triggered by stress, which lasted for weeks or even months. In both episodes, haloperidol was initially used, but there was no significant effect. In contrast, risperidone, the second-generation antipsychotic that possesses a dopamine-serotonin antagonist property, completely abolished the hiccups 6 hours after administration. This is one of few case reports in which two antipsychotics ...
Interactional Treatment of Intractable Hiccups
Family Process, 1989
This article provides a comprehensive review of the literature regarding nonmedical approaches to the understanding and treatment of intractable hiccups. The author provides a rationale for an interactional view and presents a case in which post-surgical hiccups were successfully treated, using principles developed by the Mental Research Institute. Of particular interest is the manner in which the therapist managed a system that included the victim's wife, a physician, and other medical personnel who were all trying to eliminate the hiccups. Interventions were designed primarily to alter meanings attributed to the hiccups and, thus, to intervene in the system that was maintaining the problem. This article is presented as a response to Weakland's call for research and practice in family somatics.
The Pathophysiology of Hiccups- a Comprehensive Review
2021
A hiccup is a sudden, repetitive involuntary contraction of the diaphragm and the intercostal muscles immediately followed by laryngeal closure. Hiccups are usually self-limiting, lasting up to a few minutes without any major clinical significance or the need for medical assistance. It may be the result of factors that trigger any of the three components of the reflex arc viz. the afferent limb, central limbic system or the efferent limb or any combination of neurotransmitters that assist the reflex arc. Despite its common occurrence, the pathophysiology and management of hiccups still remains unclear. Recent literature primarily consist of case reports which support the broad evidence of the numerous etiological factors and various drug treatments. Generally considered harmless, episodes of persistent or intractable hiccups may tend to have an underlying sinister pathology which may be easily overlooked. The etiopathogenesis has most often been attributed to lesions of the central ...
Systemic review: the pathogenesis and pharmacological treatment of hiccups
Alimentary pharmacology & therapeutics, 2015
Hiccups 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. To review the management of hiccups, including a systematic review of reported efficacy and safety of pharmacological treatments. Available articles were identified using three electronic databases in addition to hand searching of published articles. Inclusion criteria were any reports of pharmaceutical therapy of 'hiccup(s)', 'hiccough(s)' or 'singultus' in English or German. Treatment of 341 patients with persistent or intractable hiccups was reported in 15 published studies. Management was most effective when directed at the underlying condition. An empirical trial of anti-reflux therapy may be appropriate. If the underlying cause is not known or not treatable, then a range of pharmacological agen...
International Journal of Business Marketing and Management (IJBMM), 2019
The present article is going to highlight about my (investigator's) father who is suffering from hiccup since May 2019 till date. He is keeping under observation from medication and psychological relaxation. The purpose of this article is that one needs to understand about hiccup which is occurring across the globe but remain a poorly understand phenomenon caused by involuntary, repetatite contractions of the diaphragm and, in many cases, the intercostals muscles. The main objectives of the present article is: 1. Using medication trying to stop hiccup in initial phase; 2. Along with medication and relaxation, the client is trying to bring a state of calm mind and a body free from tension hiccup; 3. Trying to find out which diet can give more comfortable to the client under hiccup condition; 4. To observe the urine production, fart, feces excretion from the client. Does it relate to hiccup formation? Trying to find such objectives, the investigator studied a case study of 88 year old who is suffering from hiccup nearly five months till date. From this hiccup case study, the investigator found that hiccup can be controlled using medication initially and if not given the medicine, recurring hiccup came back. From this study, the investigator found that relaxation and medication is working together, then later, medication was removed and the client is able to control the recurring hiccup of his own. With regards to diet, a spicy food, difficult to digest food to the client has been avoided. Again the investigator found that from this case study it seems that if urine, fart and feces are not produced, then hiccup formation has been observed oftenly. In the conclusion part, the investigator felt that caretaker should not leave the client alone when hiccup is going on.
Challenges in the Diagnosis and Treatment of Hiccup in Neurological Patients
JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA
Hiccup is a prevalent event in the general population and can be found from milder, (so-called benign) to persistent and intractable forms. Hiccups have several causes, but stimulation of the phrenic nerve with compression, deformation and traction are among the most prevalent which could be consequence of mediastinal or lung cancer, gastric and/or esophageal distention, gastroesophageal reflux, instruments (catheters and intubation), cholecystitis, pericarditis or neurological causes. The objective of this paper is to stablish one treatment protocol and hiccup treatment in acute, persistent and intractable stages. A literature review was performed at Scielo, Pubmed, Ebsco, Clin Neuropharmacol, and ScienceDirect databases. Articles and publications from 1970 to 2015 were selected. The relevance of this article is the challenge for diagnostic and the difficulty to stablish the best plan to be addressed in cases of persistent or intractable hiccups in neurological patients, since they...
2021
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 Hiccups in neurocritical care Vanitha Rajagopalan, MBBS, MD, DNB, DM; Deep Sengupta, MBBS, DNB, DM; Keshav Goyal, MBBS, MD, DM; Surya Kumar Dube, MBBS, MD, DM; Ashish Bindra, MBBS, MD, DM; Shweta Kedia, MBBS, MD, MCh Department of Neuroanaesthesiology and Critical Care, Neuroscie...
Pharmacologic Interventions for Intractable and Persistent Hiccups: A Systematic Review
The Journal of Emergency Medicine, 2017
Background: Chlorpromazine is the only drug approved by the US Food and Drug Administration for the treatment of hiccups; however, many other pharmacologic treatments have been proposed for intractable and persistent hiccups. Currently, there is little evidence to support the use of one agent over another. Objective: This review aims to identify literature concerning the use of pharmacologic treatments for intractable and persistent hiccups with the goal of evaluating therapies in terms of their level of evidence, mechanism of action, efficacy, dosing, onset of action, and adverse effects. Methods: A systematic literature search of PubMed, Embase, the Cochrane Library, and the New York Academy of Medicine was performed to find articles where a pharmacologic agent was used to treat intractable or persistent hiccups between the years 1966 and 2016. The GRADE method was used to assess the level of evidence for the studies included in this review. Results: This review identified 26 articles involving 10 pharmacologic treatment options that met our inclusion criteria. Amitriptyline, baclofen, gabapentin, haloperidol, metoclopramide, midazolam, nifedipine, nimodipine, orphenadrine, and valproic acid were found in the literature to be successful in treating hiccups. Conclusion: Baclofen, gabapentin, and metoclopramide were the only agents that were studied in a prospective manner, while only baclofen and metoclopramide were studied in randomized controlled trials. No specific recommendations can be made for treating intractable and persistent hiccups with the evidence currently available in the literature. Therapy selection should be specific to individual patients, their underlying comorbidities, etiology of hiccups, and take into account the individual properties of the drugs.
Non-Erosive Reflux Disease Manifested Exclusively by Protracted Hiccups
Journal of Neurogastroenterology and Motility, 2010
Hiccups are a benign physiological feature affecting almost everyone at one time or another. They tend to be short-lived and do not affect quality of life; however, there are various pathologies that may present with long-lasting hiccups. These are grouped into 3 categories according to their duration: acute, persistent and intractable or protracted hiccups. Intractable hiccups last longer than 2 months and are usually associated with more severe conditions. The association between intractable hiccups and reflux disease has not been previously documented by objective methods. This report describes the case of a 23-year-old female who presented with protracted hiccups; all other organic pathologies were ruled out, and endoscopy and conventional pH-metry confirmed a diagnosis of non-erosive reflux disease as the unique cause.