Fodstad H, Nilsson S
Division of Neurosurgery, Beth Israel Medical Centre, New York.
Br J Neurosurg. 1993;7(3):255-60. doi: 10.3109/02688699309023807.
Hiccup or singultus is a repeated involuntary, spasmodic contraction of the diaphragm accompanied by a sudden closure of the glottis mediated by sensory branches of the phrenic and vagus nerves as well as dorsal sympathetic afferents. The principle efferent limb and diaphragmatic spasms are mediated by motor fibers of the phrenic nerve. Hiccup has been classified as a respiratory reflex and the central connection probably consists an interaction among the brainstem respiratory centers, phrenic nerve nuclei, medullary reticular formation and the hypothalamus. Chronic intractable hiccup may be due to brainstem seizures, and baclofen may be the long-awaited remedy for intractable hiccup as demonstrated in three illustrative cases.
呃逆或膈肌痉挛是膈肌反复不自主的痉挛性收缩，伴有声门突然关闭，由膈神经、迷走神经的感觉分支以及背侧交感传入神经介导。主要的传出支和膈肌痉挛由膈神经的运动纤维介导。呃逆被归类为一种呼吸反射，其中枢联系可能包括脑干呼吸中枢、膈神经核、延髓网状结构和下丘脑之间的相互作用。慢性顽固性呃逆可能是由于脑干癫痫发作，如三个典型病例所示，巴氯芬可能是治疗顽固性呃逆期待已久的药物。
