• The Korean Journal of Pain
• /
• v.10 no.2
• /
• pp.241-245
• /
• 1997

Persistent hiccup is defined as duration lasting longer than 48 hours. Reflex arc of hiccup is divided into three parts : afferent, central, efferent. Afferent portion of the neural pathway of hiccup formation is composed of vagus nerve, phrenic nerve, and sympathetic chain arising from T6 to T12. Efferent limb is phrenic nerve. Hiccup center is located in brain stem, midbrain, reticular system and hypothalamus. Persistent hiccup is very difficult to treat by conventional methods. We performed cervical epidural block of the phrenic nerve root for three patients suffering from persistent hiccup. The therapeutic effect was perfect. The mechanism of the cervical epidural block is not yet defined however it is thought to block the efferent nerve fibers and suppress the reflex arc of hiccup. We conclude cervical epidural block is relatively safe and very effective for treating persistent hiccup.

• Journal of Sasang Constitutional Medicine
• /
• v.16 no.2
• /
• pp.105-113
• /
• 2004

1. Objectives Hiccup is one of common symptoms clinically and caused by various etiologies. Persistent hiccup is defined as hiccup lasting more than 48 hours. We have tried researching effect of herbal medicines(Dokhwaljihwang-tang, Yangkyuksanhwa-tang). 2. Methods To heal the persistent hiccup, we used Dokhwaljihwang-tang and Yangkyuksanhwa-tang. 3. Results A Soyangin patient diagnosed to have persistent hiccup was, treated with Soyangin herbal medicines (Dokhwaljihwang-tang and Yangkyuksanhwa-tang), and change of his symptom & general condition was managed. 4. Conclusions The constitutional treatment with Soyangin herbal medicines(Dokhwaljihwang-tang, Yangkyuksanhwa-tang) may have an effect on management of persistent hiccup. Further study on management of this disease is needed.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.22 no.6
• /
• pp.1621-1625
• /
• 2008

Generally, hiccup is a temporary symptom, however, persistent or intractable hiccup that repeats continuously or does not respond to medical treatments makes the patients very painful. In this case, a seventy-two years old patient with pontine infarction showed symptoms as aspiration pneumonia and persistent hiccup a few days after hospitalized. We considered him as excess heat pattern and prescribed Yangkyuk-san. In the result, not only the frequency and intensity of hiccup were remarkably decreased but also the inflammation and overall symptoms by pontine infarction were improved.

• Journal of Sasang Constitutional Medicine
• /
• v.22 no.3
• /
• pp.152-159
• /
• 2010

1. Objectives: This study aims to report symptomatic improvement of a Soyangin persistent hiccup patient with Hyeongbangdojeoksan. 2. Methods: The patient was treated with Hyeongbangdojeok-san and acupunctural therapy. The patient's chief complaint and ordinaty symptoms were observed during the outpatient care period. 3. Results and Conclusions: In results, Soyangin patients's hiccup and ordinary symptom as well as improved. The management of the constitutional pathological syndromes by constitutional perspective than focusing on the symptoms of hiccups will provide more comfortable life and better health levels.

• Tuberculosis and Respiratory Diseases
• /
• v.64 no.1
• /
• pp.39-43
• /
• 2008

A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.

• The Korean Journal of Pain
• /
• v.8 no.1
• /
• pp.131-134
• /
• 1995

Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.

• The Journal of Internal Korean Medicine
• /
• v.26 no.2
• /
• pp.506-511
• /
• 2005

Hiccup is a common clinical symptom, and may be caused from over 100 medical origins. Generally hiccup happens temporarily, and continues only a few seconds or minutes, and is cured easily by physical methods or even by itself. But in some cases, hiccup is so refractory that patients may be tired and very troubled by it. At worst, it may cause death. Intractable hiccup is defined as hiccup persisting for more than 48 hours, and this appears in various diseases. Persistent hiccup is very difficult to treat by conventional methods. A 69-year-old man was admitted due to intractable hiccup without gastroenteral system abnormalities or peripheral nervous systemic involvement. So Paljung-san(八正散) was prescribed. The intensity and frequency of hiccup dramatically improved.

• The Journal of Internal Korean Medicine
• /
• v.22 no.1
• /
• pp.95-101
• /
• 2001

Hiccups is one of the omnipresent phenomenon occurring in everyone. Most episodes are time-limited, but, sometimes, they become intractable and protracted for a long time. In most cases, they are idiopathic. But, sometimes there are cases which have diverse kinds of underlying disorders. In this study, the author reports a case of idiopathic and persistent hiccups. He recently encountered a 64 year old male patient with intractable and persistent hiccups for over two weeks. By using the method of 8 Constitutional Acupuncture therapy and herbal medication( Hyangsapyeungwutang) regarding him as RENOTONIA. After 7days of treatment, the symptoms disappeared.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.222-225
• /
• 2005

Hiccups are due to an intermittent clonic spasm of the diaphragm. In most cases, hiccups are self-limiting disease, but persistent hiccups may be related to the presence of serious underlying systemic disease. Two patients who had persistent hiccups that were not controled by conventional methods and medications were referred to the pain clinic. We administered a single oral medication of gabapentin, and then the hiccups disappeared in both cases. We concluded that gabapentin should be considered as an alternative therapy to control persistent or intractable hiccup. It could be particularly useful for those patients with solid malignancies, either alone or as an "add-on therapy" with other oral agents.

• The Korean Journal of Pain
• /
• v.23 no.3
• /
• pp.198-201
• /
• 2010

Persistent and intractable hiccups (with respective durations of more than 48 hours and 1 month) can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration syndromes. The conventional treatments for hiccups are either non-pharmacological, pharmacological or a nerve block treatment. Pulsed radiofrequency lesioning (PRFL) has been proposed for the modulation of the excited nervous system pathway of pain as a safe and nondestructive treatment method. As placement of the electrode in close proximity to the targeted nerve is very important for the success of PRFL, ultrasound appears to be well suited for this technique. A 74-year-old man suffering from intractable hiccups that had developed after a coronary artery bypass graft and had continued for 7 years was referred to our pain clinic. He had not been treated with conventional methods or medications. We performed PRFL of the phrenic nerve guided by ultrasound and the hiccups disappeared.