Medullary neurosarcoidosis presenting with intractable hiccoughs

Seby John*, Joseph Parambil, Daniel Culver, Jinny Tavee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Hiccoughs (singultus) are a complex physiological process characterized by sudden brief involuntary contractions of the diaphragm. They most commonly occur from peripheral mechanisms that result in diaphragmatic irritation, but also occur from brain stem lesions such as that seen in Wallenberg's syndrome. They are uncommon in sarcoidosis and it is remarkably rare when hiccoughs are the presenting symptom of neurosarcoidosis. We report a patient with sarcoidosis who presented with intractable hiccoughs due to an inflammatory medullary lesion. Evaluation revealed an enhancing lesion in the dorsomedial medulla that resolved after aggressive immune-modulating therapy. In the absence of a clear peripheral lesion that would potentially affect the diaphragm, the diagnosis of neurosarcoidosis involving the brainstem should be considered in patients with sarcoidosis.

Original languageEnglish (US)
Pages (from-to)1193-1195
Number of pages3
JournalJournal of Clinical Neuroscience
Volume19
Issue number8
DOIs
StatePublished - Aug 2012

Keywords

  • Hiccoughs
  • Isolated medullary lesion
  • Neurosarcoidosis

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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