J Korean Child Neurol Soc.  2014 Sep;22(3):165-168.

Successful Treatment of Intractable Hiccups with Benztropine

• Kim YS
• Yu HJ
• Kim JY
• Lee M
• Lee J

Abstract

In general, intractable hiccups are uncommon. Various drugs and interventions have been reported, but there is no consensus on the treatment of intractable hiccups. We report a patient with meningitis and rhombencephalitis who presented with intractable hiccups that were resolved following treatment with benztropine. A 17-year-old boy was admitted to another hospital with a two-week history of fever and headache. A cerebrospinal fluid (CSF) test showed an increased white blood cell (WBC) count (290/muL, monocytes 100%). He was diagnosed with meningitis and treated with ceftriaxone. Two days after admission, hiccups started and lasted for eight days, despite treatment with phenobarbital, diazepam, haloperidol, phenytoin, and chlorpromazine. He was transferred to our hospital for further evaluation and treatment. He was clinically diagnosed with rhombencephalitis based upon the findings of brain magnetic resonance imaging (MRI). The fever and headache disappeared one day later. However, the hiccups persisted, despite symptomatic treatment with chlorpromazine, gabapentin, and metoclopramide. The hiccups disappeared after one day of adding benztropine without relapse. Benztropine can be considered in the treatment of intractable hiccups.

Keyword

Hiccups; Meningitis; Encephalitis; Benztropine

MeSH Terms

Adolescent
Benztropine*
Brain
Ceftriaxone
Cerebrospinal Fluid
Chlorpromazine
Consensus
Diazepam
Encephalitis
Fever
Haloperidol
Headache
Hiccup*
Humans
Leukocytes
Magnetic Resonance Imaging
Male
Meningitis
Metoclopramide
Monocytes
Phenobarbital
Phenytoin
Recurrence
Benztropine
Ceftriaxone
Chlorpromazine
Diazepam
Haloperidol
Metoclopramide
Phenobarbital
Phenytoin