Abstract
A 64-year-old male suffering hiccups for 14 years appeared in the clinic. His intractable hiccups led him to alcoholism, because hiccups drew vomiturition of solid foods. Oral medication of carbamazepine, baclofen, valproic acid, chlorpromazine or harbal medicine “Shakuyaku-kanzo-to” were not effective for ceasing his hiccups. Cervical epidural block and phrenic nerve block were also not effective, and stellate ganglion block worsened his hiccups. Although oral diazepam or clonazepam were slightly effective, the patient was not tolerate to effective doses of these drugs. Finally, I found that the hiccups of this patient had decreased efficaciously with oral amitriptyline, propranolol, low dose of clonazepam and temporary vagus nerve block. Considering that GABA receptors have some role in decreasing hiccups, the nil effect of baclofen and the others seemed to suggest that intractable hiccups may not be treated by only one medication. So beta antagonist and vagus nerve block, even though there are a few reports, should be considered for this kind of patients. It would be notable that the cure of hiccups treated his alcoholism by decrease of vomiturition.
