Brain Neurorehabil.  2018 Mar;11(1):e2. 10.12786/bn.2018.11.e2.

Phrenic Nerve Clipping in a Stroke Patient with Intractable Hiccup: a Case Report

• Yoon JR
• Ko YD
• Yun SI
• Chung ME

• KMID: 2408838
• DOI: http://doi.org/10.12786/bn.2018.11.e2

Abstract

Hiccup is an intermittent, involuntary and erratic contraction of the diaphragm, immediately followed by a laryngeal closure. Persistent and intractable hiccups are rare but severe, keeping a person from doing daily activities; these can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration. Therefore, proper treatments are necessary. We present a case with intractable hiccup treated with an unusual treatment. A 61-year-old man presented with intractable hiccups, which started 6 years ago after subarachnoid and intraventricular hemorrhage. Conventional pharmacologic treatments including metoclopramide, gabapentin, and baclofen were unsuccessful. Cooperating with cardiothoracic surgeons, phrenic nerve clipping operation was done under intraoperative electrophysiologic monitoring. This method was successful that the symptoms were relieved. Reversible clipping done under intraoperative electrophysiologic monitoring can be a promising therapeutic method for persistent and intractable hiccups in patients with stroke.

Keyword

Hiccup; Phrenic Nerve; Electromyography

MeSH Terms

Baclofen
Dehydration
Depression
Diaphragm
Electromyography
Fatigue
Hemorrhage
Hiccup*
Humans
Malnutrition
Methods
Metoclopramide
Middle Aged
Phrenic Nerve*
Stroke*
Surgeons
Weight Loss
Baclofen
Metoclopramide