An Experimental Study of Hiccup

Hiccups: a common problem with some unusual causes and cures

“…Physiological studies have demonstrated a mechanism by which these manoeuvres improve hiccups, with the frequency of hiccups decreasing as arterial PCO 2 rises. 6 In the case of persistent hiccups, the following drugs are used: haloperidol 2-5 mg/24 hr, metoclopramide 10 mg, baclofen 7 5 mg/8 hr, phenytoin, valproic acid, carbamazepine, gabapentin, amitriptyline, and amantadine. 8 Chlorpromazine 25-50 mg intramuscularly or intravenously is effective in up to 80% of cases.…”

About the Mechanism of Hiccup

“…Through the centuries it was suggested that the mecha nism of He was: (1) gastrointestinal distension or reflex; (2) epileptic seizure; (3) postanoxic syndrome; (4) dia phragmatic myoclonus or extrasystolia; (5) phrenic nerve excitation; (6) cerebral disorder; (7) brainstem disorder; (8) chronobiologic disturbance; (9) psychosomatic event; (10) vestigial reflex; (11) fetal breathing or gasping [8,II,12. 18,22,[26][27][28]31.32,35,37], All these suggested that mechanisms are small facets of a unique complex.…”

“…The valve function is coordinated by a supra nuclear center located in the brainstem reticular sub stance. interrelated with respiratory centers [8,13,14], This supranuclear center, named by Lewis 'the hiccup center', is connected to cerebellum, hypothalamus and cerebral hemispheres [5. 12], The connections consist of a multiafferent pathway involving the V. VI.…”

“…At the end of this increasing frequency wave, the flow of sudden action potentials responsible for the He diaphragm contraction, occur. He appears during inspiration and extremely rarely during expiration [5,8], Davis [8] recorded the electromyogram of the diaphragm and intercostal muscles simultaneously with pulmonary functions through a pneumotachograph in 3 subjects. He showed that He amplitude is independent of the degree of excitation of the respiratory centers or arterial pCCL and concluded that He is mediated by a supraspinal mecha nism independent of the breathing mechanism and trig gered by intra-abdominal stimuli [8].…”

Treatment of Intractable Hiccup in Haemodialysis Patients with Baclofen

“…Hiccup is defined as an involuntary, intermittent spasmodic contraction of the diaphragm and the inspiratory intercostal muscles that results in a sudden inspiration and ends with an abrupt closure of the glottis [1]. Hiccup is usually a self-limited episode and rarely becomes persistent and intractable.…”