Moretti Rita, Torre Paola, Antonello Rodolfo M, Ukmar Maja, Cazzato Giuseppe, Bava Antonio
Dipartimento di Fisiologia e Patologia, Università degli Studi di Trieste, Italy.
Neurologist. 2004 Mar;10(2):102-6. doi: 10.1097/01.nrl.0000117824.29975.e7.
Persistent and intractable hiccups indicate multiple neurologic and extraneurologic disorders. Chronic hiccup is not so rare in patients suffering from stroke: its impact on quality of life and on rehabilitation management is substantial, and it may be closely related to aspiration pneumonia, respiratory arrest and nutritional depletion.
Intractable hiccups can be associated with potentially fatal consequences and safe management may require inpatient rehabilitation. It has been suggested that hiccups could be a form of myoclonus, caused by repeated and abnormal activity of the solitary inspiratory nucleus. Because of this cause we decided to treat intractable hiccups in patients with ischemic lesions of the medulla with a short course of gabapentin.
The results were promising, with the immediate disappearance of the hiccups, and the complete absence of side effects. The 36-months follow up was favorable to all the patients, who, after 6 days of treatment remain asymptomatic.
持续性和顽固性呃逆提示多种神经系统和非神经系统疾病。慢性呃逆在中风患者中并不罕见：它对生活质量和康复管理有重大影响，并且可能与吸入性肺炎、呼吸骤停和营养消耗密切相关。
顽固性呃逆可能伴有潜在的致命后果，安全的管理可能需要住院康复治疗。有人提出呃逆可能是一种肌阵挛形式，由孤立吸气核的反复异常活动引起。基于这一原因，我们决定用短疗程加巴喷丁治疗延髓缺血性病变患者的顽固性呃逆。
结果令人鼓舞，呃逆立即消失，且完全没有副作用。36个月的随访对所有患者都很有利，治疗6天后他们均无症状。
