Intractable hiccups as a presenting feature of clinically isolated syndrome

Abstract

We report a 15-year-old girl with intractable hiccups unresponsive to high doses of proton pump inhibitors. Further investigations revealed an acute demyelinating neurological disorder on magnetic resonance imaging of the brain with a lesion in the brain stem responsible for the hiccups. Hiccups are a common and usually transient condition. It is rare for it to become intractable. Persistent hiccups may reflect a serious underlying disease, as in our case due to a demyelinating disorder. We would like to highlight the underlying causes of an acute demyelinating neurological disorder and the characteristics to help with the differential diagnosis.

Keywords

Acute demyelinating neurological disorder - acute disseminated encephalomyelitis - hiccups - clinically isolated syndrome