Treatment modalities for hiccups (Singultus)?

[Natasha]

Hello, a 19-year-old man in which intractable hiccups was the first and most prominent symptom of a serious underlying neurologic disorder. The patient had been examined by his pediatrician, and despite multiple medical regiments and physical maneuvers, his symptoms persisted. A thorough head and neck examination revealed a right-sided vocal cord paralysis. This finding prompted obtaining a magnetic resonance imaging scan, which demonstrated a type I Arnold-Chiari malformation associated with a large cervicothoracic syringomyelia. The patient was referred to the neurosurgical service and subsequently underwent a ventriculo-peritoneal shunt placement. There was considerable initial improvement in his neurologic status and cessation of the hiccups. However, the symptoms recurred within 1 month. What are the treatment modalities for hiccups (Singultus)?

[Puneet]

@natasha The treatments proposed for curing hiccups are as diverse and numerous as the suggested causes. This fact alone bears testimony to the lack of uniform efficacy of any single remedy. Most episodes of hiccups are brief and abate spontaneously without any therapy. In those cases in which a specific cause can be identified, elimination or treatment of the causative factor would be the most logical first therapy. For simplicity, therapy can be divided into three categories: physical maneuvers, drug therapy, and surgical therapy. When conservative measures and physical maneuvers fail to control hiccups, a trial of drug therapy may be attempted. A variety of pharmacologically diverse medications have been tried with variable success. Most reports are based on anecdotal clinical observation rather than controlled scientific studies. A partial listing of these medications would include major tranquilizers, anticonvulsants, CNS stimulants, muscle relaxants, local anesthetics, and dopamine-serotonin antagonists