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Hiccups (Myoclonus)
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 Myoclonus
Mereck Manual Myoclonus

Myoclonus describes fleeting bursts of muscular excitation or relaxation, resulting in a synchronous quick jerk of the muscles involved. 

Myoclonic jerks may affect most muscles at once, as commonly occurs when a person first falls asleep. They also may be confined to a single hand, a group of muscles in the upper arm or leg, or even a group of facial muscles. Multifocal myoclonus is caused by a sudden lack of oxygen to the brain, certain types of epilepsy, or degenerative late-life diseases.

If the myoclonic jerks are so severe that they require treatment, antiseizure drugs such as clonazepam or valproic acid are sometimes helpful.

Hiccups

Hiccups, a form of myoclonus, are repeated spasms of the diaphragm (the muscle that separates the chest from the abdomen), followed by quick, noisy closings of the glottis (the opening between the vocal cords that checks the flow of air to the lungs).

Hiccups can develop when a stimulus triggers the nerves that contract the diaphragm. The nerves involved may be those that lead to and from the diaphragm, or--because contraction of the diaphragm is responsible for each breath--they may be the nerves leading to and from the area in the brain that controls breathing.

Most bouts of hiccups are harmless. They begin suddenly, usually without an obvious cause, and they usually stop spontaneously after several seconds or minutes. Sometimes a bout of hiccups is triggered by swallowing hot or irritating food or liquids.

 

Hiccups continued

Less common but more serious causes of hiccups include irritation of the diaphragm from pneumonia, chest or stomach surgery, or harmful substances in the blood (such as those that build up when a person has kidney failure).

Rarely, hiccups develop when a brain tumor or stroke interferes with the breathing center in the brain. These more serious disorders may lead to long bouts of hiccups that are very hard to stop.

Treatment

Many home remedies have been used to cure hiccups. Almost all are based on the fact that when carbon dioxide accumulates in the blood, hiccups generally stop.

Since holding the breath increases carbon dioxide in the blood, most cures for hiccups require holding the breath. Breathing into a paper bag also raises carbon dioxide levels.

Because stimulating the vagus nerve that runs from the brain to the stomach may help, drinking water quickly or swallowing dry bread or crushed ice may stop the hiccups.

Gently pulling on the tongue and gently rubbing the eyeballs are other ways to stimulate the vagus nerve. For most people with hiccups, any of these remedies will work.

Persistent hiccups require more intensive treatment.  Several drugs have been used with varying success; they include scopolamine, prochlorperazine, chlorpro-mazine, baclofen,metoclopramide, and valproate. The very length of the list reflects the lack of consistent success.