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Hiccups: an atypical presentation of lateral medullary syndrome

Zainulabid, Ummu Afeera and Che Mohamed, Siti Kamariah and Jaafar, Khairul Azhar (2021) Hiccups: an atypical presentation of lateral medullary syndrome. Journal of Cardiovascular, Neurovascular & Stroke, 3 (3). pp. 8-14. E-ISSN 2600-7800 (Online)

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Abstract

Background: Persistent hiccup related to lateral medullary syndrome is rarely reported as usually it resembles other gastrointestinal abnormality. It is often overlooked and can cause aspiration pneumonia. Methods: We report a case of an elderly man who presented with persistent hiccups and later diagnosed to have lateral medullary syndrome. Results: 73-year-old Malay male presented with desaturation and persistent hiccups. On further history, he complained of giddiness, right sided body weakness and recurrent choking episode. On clinical examination, he was found to have right sided Horner syndrome, right ataxia and left sided sensory loss and dysphagia. CT Brain showed multifocal lacunar infarctions. Due to suspicious of posterior circulation stroke, urgent MRI was done and showed features of acute right lateral medullary infarction with small haemorrhagic transformation most likely due to arterial thrombus within the right vertebral artery. He was treated for ischemic stroke and aspiration pneumonia. Conclusion: Persistent hiccups is one of unique presentation that can occur in a case of lateral medullary syndrome. It was postulate that there is denervation super sensitivity due to palatal myoclonus in this group of patients.

Item Type: Article (other)
Uncontrolled Keywords: Lateral Medullary Syndrome; Hiccup
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Internal Medicine
Depositing User: Asst. Dr. Ummu Afeera Zainulabid
Date Deposited: 08 Oct 2021 11:42
Last Modified: 08 Oct 2021 11:42
URI: http://irep.iium.edu.my/id/eprint/92795

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