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Lesional location of lateral medullary infarction presenting hiccups (singultus)
  1. M H Park,
  2. B J Kim,
  3. S B Koh,
  4. M K Park,
  5. K W Park,
  6. D H Lee
  1. Department of Neurology, Korea University Medical College, Seoul, Republic of Korea
  1. Correspondence to:
 Dr Dae Hie Lee
 Department of Neurology, Korea University Medical College, 126–1, Anam-dong-5-ga, Sungbuk-gu, Seoul 136–705, Republic of Korea;


Background: Hiccups are an infrequent result of lateral medullary infarction. Their importance may be underestimated and they can cause distress, exhaustion, and aspiration. Hiccups in lateral medullary infarction remain poorly understood

Objective: To evaluate the relation between the lesional loci of lateral medullary infarction and hiccups.

Methods: 51 patients with lateral medullary infarction were investigated by magnetic resonance imaging within three days of the onset of infarction. Seven of the 51 patients developed hiccup.

Results: All patients with hiccups had middle level lateral medullary lesions, including two with lower level lesions and four with upper level lesions. In the middle level lateral medullary lesions, dorsolateral lesions were most often involved. All patients with lateral medullary infarction presenting with hiccups also had vertigo, dizziness, nausea, vomiting, and dysphagia.

Conclusions: The observations suggest that middle level and dorsolateral lesion locations in lateral medullary infarction frequently induce hiccups.

  • DL, dorsolateral
  • GCC, glottis closure complex
  • IC, inspiratory complex
  • ID, inferior-dorsal
  • IDL, inferior-dorsolateral
  • LMI, lateral medullary infarction
  • ML, midlateral
  • PM, paramedian
  • medulla oblongata
  • cerebral infarction
  • hiccup

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  • Competing interests: none declared