Hiccups Attributable to Syringobulbia and/or Syringomyelia Associated with a Chiari I Malformation: Case Report

Toshitaka Seki, Kazutoshi Hida, Jang Bo Lee, Yoshinobu Iwasaki, Harald Fodstad, Robert G. Grossman, Arnold H. Menezes

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Approximately 20 to 50% of patients with syringomyelia associated with Chiari malformations exhibit cranial nerve or cerebellar symptoms. However, hiccups represent a rare clinical manifestation of this disorder. We report a case of intractable hiccups resulting from syringobulbia associated with a Chiari I malformation, which was successfully treated with foramen magnum decompression. CLINICAL PRESENTATION: We report the case of a patient who presented with syringomyelia and syringobulbia associated with a Chiari I malformation, manifested as intractable hiccups and neurological deficits. Magnetic resonance imaging scans demonstrated syringobulbia in the dorsal medullary region and a large cervical syrinx from C2 to C6-C7, associated with a Chiari I malformation. INTERVENTION: Foramen magnum decompression and a C1 laminectomy were performed. One month later, the intractable hiccups disappeared and the neurological symptoms demonstrated improvement. CONCLUSION: Postoperative magnetic resonance imaging scans demonstrated enlargement of the subarachnoid space in the posterior fossa and disappearance of the syringobulbia. There has been no recurrence of intractable hiccups and syringobulbia in 6 months after surgery. Magnetic resonance imaging of the brainstem is an important diagnostic procedure for intractable hiccups, because syringobulbia associated with a Chiari malformation represents a surgically treatable disorder, although the incidence is low.

Original languageEnglish
Pages (from-to)224-227
Number of pages4
JournalNeurosurgery
Volume54
Issue number1
DOIs
Publication statusPublished - 2004 Jan
Externally publishedYes

Keywords

  • Chiari malformation
  • Foramen magnum decompression
  • Hiccups
  • Syringobulbia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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