Witoonpanich Rawiphan, Pirommai Busaya, Tunlayadechanont Supoch
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University.
J Med Assoc Thai. 2004 Oct;87(10):1168-71.
Hiccups is a rare and unfamiliar presenting symptom of multiple sclerosis. Patients admitted to Ramathibodi Hospital from 1969 to 1992 who had a clinical diagnosis of multiple sclerosis were reviewed The presenting symptoms and neurological signs were analysed. The clinical features and course of the disease of cases who initially presented with intractable hiccups were studied in detail. There were 4 cases out of a total of 47 cases (8.5%) who presented with hiccups. These patients all had relapse and remission and two of them had a rather fulminant course of illness. Therefore, multiple sclerosis should be seriously considered as a possible cause of intractable hiccups. It may be of benign or malignant form. In the latter, the patients may develop quadriparesis within hours or days and respiratory failure may ensue. They usually respond well to high dose intravenous corticosteroids especially pulse methylprednisolone.
呃逆是多发性硬化症一种罕见且不常见的症状表现。对1969年至1992年入住拉玛提波迪医院且临床诊断为多发性硬化症的患者进行回顾。分析其症状表现及神经体征。对最初以顽固性呃逆为表现的病例的临床特征及病程进行详细研究。在总共47例病例中有4例（8.5%）以呃逆为表现。这些患者均有复发和缓解情况，其中2例病情发展较为迅猛。因此，应认真考虑多发性硬化症作为顽固性呃逆可能病因。它可能呈良性或恶性形式。在恶性形式中，患者可能在数小时或数天内发展为四肢瘫痪，并可能继而出现呼吸衰竭。他们通常对大剂量静脉注射皮质类固醇尤其是脉冲式甲泼尼龙反应良好。
