Table 1.

Causes of persistent hiccups

Central nervous system disordersVascular
Ischaemic/haemorrhagic stroke, AV malformations, temporal arteritis Infections
Encephalitis, meningitis, brain abscess, neurosyphilis, subphrenic abscess Structural
Head trauma, intracranial neoplasms, brainstem neoplasms, multiple sclerosis, syringomyelia, hydrocephalus
Vagus and phrenic nerve irritationGoitre, pharyngitis, laryngitis, hair or foreign-body irritation of tympanic membrane, neck cyst or other tumour
Gastrointestinal disordersGastric distention, gastritis, peptic ulcer disease, pancreatitis, pancreatic cancer, gastric carcinoma, abdominal abscesses, gallbladder disease, inflammatory bowel disease, hepatitis, aerophagia, oesophageal distention, oesophagitis, bowel obstruction
Thoracic disordersEnlarged lymph nodes secondary to infection or neoplasm, pneumonia, empyema, bronchitis, asthma, pleuritis, aortic aneurysm, mediastinitis, mediastinal tumours, chest trauma, pulmonary embolism
Cardiovascular disordersMyocardial infarction, pericarditis
Toxic–metabolicAlcoholDiabetes mellitus
Herpes zosterHypocalcaemia
HypocapniaHyponatraemia
InfluenzaMalaria
TuberculosisUraemia
PostoperativeGeneral anaesthesiaGastric distention
Intubation (stimulation of glottis)Traction on viscera
Neck extension (stretching phrenic nerve roots)
DrugsAlpha methyldopaDexamethasone
Short-acting barbituatesDiazepam
Chemotherapeutic agents (for example, carboplatin)
PsychogenicAnorexia nervosaMalingering
Conversion reactionSchizophrenia
ExcitementStress