Hiccup is produced by a sudden contraction of the inspiratory muscles followed by an abrupt closure of the glottis, which produces the typical sound that characterizes this disorder. The causes of hiccup are diverse, 1 including several drugs. 2 Here, we report two cases of patients with Parkinson's Disease (PD) who developed hiccup after using different dopamine agonists (DAs). CLINICAL CASES Case 1This 76-year-old man with a history of arterial hypertension, acute myocardial infarction (AMI) in 1988, and hypercholesterolemia developed progressive resting tremor and bradykinesia, initially involving the left side of his body and later becoming bilateral.He was given a diagnosis of PD 7 years ago and received levodopa/benserazide (500/120 mg/day) and piribedil (150 mg/ day) divided in three doses for the last 8 months. However, because of economic reasons and issues related to his medical insurance, the patient asked if he could change piribedil for another drug. To this end, he started pramipexol (3 mg/day). Two hours after taking the first pramipexol dose, however, he developed hiccups, which persisted for 3 days and stopped after discontinuing pramipexol. He was then switched back to piribedil at a higher dose than his original prescription (200 mg/day) but once again hiccups developed. They stopped after he decreased the dose to 150 mg/day.

We report the case of a 29-year-old male patient with a generalized and progressive dystonia that led him unable to stand. Multiple antidystonic treatments were tried without benefit. Alcohol test was positive with a dramatic improvement. To the best of our knowledge, this is the first reported case of generalized dystonia without other clinical manifestations sensitive to alcohol.

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