Persistent hiccups following thalamic hemorrhage: A case report

Efficacy of high-frequency peripheral magnetic stimulation in treating patients with persistent hiccups post-stroke: A retrospective study

BACKGROUND

This study retrospectively evaluated the efficacy and safety of peripheral magnetic stimulation for treating persistent hiccups in patients after stroke.

METHODS

In this retrospective study, we categorized patients with persistent hiccups post-stroke admitted to the Rehabilitation Medicine Department of Wuhan University People's Hospital between May 2022 to August 2023 into two groups. The experimental group received 10 Hz peripheral magnetic stimulation targeting the phrenic nerve, whereas the control group received a daily intramuscular injection of 10 mg metoclopramide. Treatment efficacy over a 3-day period, hiccup scores before and after treatment, and overall clinical efficacy were compared between the two groups.

RESULTS

Seventeen patients diagnosed with persistent hiccups post-stroke were included, with nine in the control group and eight in the experimental group. There were no significant differences between the two groups in terms of the number of hiccups, hiccup scores, or age prior to treatment. After 3 days of treatment, the clinical efficacy was 55.56 % for the control group and 100 % for the experimental group (P = 0.01). Three patients in the control group experienced adverse reactions, whereas no adverse reactions were observed in the experimental group (P = 0.036).

CONCLUSIONS

High-frequency peripheral magnetic stimulation may be more effective and associated with fewer adverse effects than metoclopramide injections for patients with intractable post-stroke hiccups. Our findings suggest a novel therapeutic strategy for managing persistent hiccups following a stroke.

Hiccups: Nerve Irritation or Masquerading as Acute Coronary Syndrome

The typical clinical presentation of acute coronary syndrome (ACS) includes chest pain that may radiate to the left arm, shoulder, jaw, and neck, accompanied by diaphoresis, dyspnea, nausea, vomiting, and hiccups, which have been observed as the sole symptom of presentation. The mechanism of hiccups involves the activation of the vagus and phrenic nerves, leading to the activation of the diaphragm and intercostal muscles. Several hypotheses link hiccups to ACS, associating irritation of the left anterior descending artery with activation of sympathetic phrenic and vagal nerves. This case report highlights the occurrence of hiccups in patients with inferior and right ventricular myocardial infarction (MI), indicating possible nerve synapse involvement. Timely recognition of hiccups as a possible atypical symptom of ACS can facilitate early evaluation and management, preventing delays in patient care and ensuring better outcomes.