Chonnam Med J.
2003 Sep;39(3):185-189.
A Case of Combination Therapy with Cisapride, Omeprazole, and Gabapentin for Intractable Chronic Hiccup in Stroke Patient
- Affiliations
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- 1Department of Physical Medicine and Rehabilitation, Chonnam National University Medical School, Gwangju, Korea. Lee9299@cnuh.com
- 2Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Korea.
- 3Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
- 4Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Abstract
- Hiccup is a repeated involuntary spasmodic contraction of the diaphragm and accessory inspiratory muscles followed by the sudden closure of the glottis. Intractable chronic hiccup is an unusual and severe hiccup lasting longer than one month which usually results in serious complications such as malnutrition, sleep impairment, weight loss, exhaustion and anxiety or depression. The patient was a 67-year-old male, admitted for depressed mental status associated with intracranial hemorrhage on left basal ganglia. No peripheral organic causes of intractable chronic hiccup, such as gastrointestinal and diaphragmatic abnormalities, were found. Empirical maneuvers and vagal stimulation had no effect. At first, we tried the combination regimen: cisapride, omeprazole, and baclofen (COB). Thirteen days of COB regimen, considerably improved the hiccup; however, his mental state was deteriorated too deep to carry out rehabilitative treatment, and severe drooling also developed, suggestive of baclofen side effect. Thus, we substituted gabapentin (COG) for baclofen of COB. After eight days of COG regimen he was relieved from intractable hiccup without any side effect. On this account we recommand the COG combination for the baclofen-limited stroke patients with intractable chronic hiccup as a favorable regimen.
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