Funakawa I, Yasuda T, Terao A
Department of Neurology, Kawasaki Medical School.
Rinsho Shinkeigaku. 1992 Jul;32(7):733-8.
A 48-year-old female with multiple sclerosis (MS) accompanied by intractable hiccups of over one month' duration and the sleep apnea syndrome was reported. This MS patient had been well controlled until September 16, 1991 when she experienced nausea, vomiting and hiccups. The patient was admitted to Kawasaki Medical School Hospital on October 9, 1991. A physical examination revealed intractable hiccups. T1-weighted MRI showed a low and T2-weighted image disclosed a high signal intensity area in the tegmentum of the medulla oblongata. The intractable hiccups and vomiting improved with intravenous high dose methylprednisolone injection therapy. The following day, she complained of insomnia and her family observed severe snoring and apnea during the night. These symptoms and the results of a breathing monitor were compatible with the sleep apnea syndrome. These symptoms disappeared following the administration of amitriptyline. There have been few reports of the combination of intractable hiccups and the sleep apnea syndrome in MS. The MRI findings suggest that the causative lesion of these symptoms is in the tegmentum of the medulla oblongata.
报道了一名48岁患有多发性硬化症（MS）的女性，伴有持续一个多月的顽固性呃逆和睡眠呼吸暂停综合征。该MS患者病情一直得到良好控制，直到1991年9月16日出现恶心、呕吐和呃逆。患者于1991年10月9日入住川崎医科大学医院。体格检查发现顽固性呃逆。T1加权磁共振成像（MRI）显示延髓被盖区信号减低，T2加权像显示高信号强度区。静脉注射大剂量甲基强的松龙治疗后，顽固性呃逆和呕吐有所改善。第二天，她主诉失眠，家人观察到她夜间严重打鼾和呼吸暂停。这些症状及呼吸监测结果与睡眠呼吸暂停综合征相符。服用阿米替林后这些症状消失。关于MS患者出现顽固性呃逆和睡眠呼吸暂停综合征合并存在的报道很少。MRI结果提示这些症状的致病病变位于延髓被盖区。
