Lesional location of intractable hiccups in acute pure lateral medullary infarction
- Author:
Chan-O Moon
;
Sung-Hee Hwang
;
Seong Sook Hong
;
San Jung
;
Seok-Beom Kwon
- Publication Type:Journal Article
- From:Neurology Asia
2014;19(4):343-349
- CountryMalaysia
- Language:English
-
Abstract:
Background & Objective: Hiccups is a disabling condition of lateral medullary infarction (LMI).
Unlike other symptoms of LMI, the anatomical lesions of hiccups are not well known. Few studies
have evaluated the relationship between the lesional location of LMI and hiccups. We performed this
study to correlate hiccups and magnetic resonance imaging (MRI)-based lesional location in pure
LMI. Methods: Between January 1997 and February 2013, we identified 24 patients with pure LMI
who presented with hiccups in addition to typical lateral medullary syndrome. Sixty six pure LMI
patients without hiccups were included as a control group. Clinical and radiologic findings were
compared between the two groups. MRI-identified lesions were classified rostrocaudally as rostral,
middle and caudal, and horizontally as typical, ventral, large, lateral and dorsal. Results: The pure
LMI patients with hiccups had significantly more frequent aspiration pneumonia (P = 0.001) and
longer hospital stay (P = 0.03). The patients with hiccups significantly more often had dorsal rather
than ventral lesion at horizontal levels (P = 0.012). But, there were no rostro-caudal differences at
vertical levels (P = 0.162).
Conclusions: We suggest that pure LMI associated with hiccups often locates in the dorsal medulla
at horizontal correlation. This MRI-based comparative study has advanced the understanding of the
neural substrate for hiccups in LMI, and indicates that hiccups become predictable when specific
lesional locations in the lateral medulla are considered.
- Full text:P020150630578653513242.pdf
