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NEUROLOGY 2005;65:1479-1482
© 2005 American Academy of Neurology
Brief Communications

Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica

T. Misu, MD, PhD, K. Fujihara, MD, PhD, I. Nakashima, MD, PhD, S. Sato, MD, PhD and Y. Itoyama, MD, PhD

From the Department of Neurology (Drs. Misu, Fujihara, Nakashima, and Itoyama), Tohoku University Graduate School of Medicine, Sendai, Japan; and the Department of Neurology (Dr. Sato), Kohnan Hospital, Sendai, Japan.

Address correspondence and reprint requests to Dr. T. Misu, Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; e-mail: misu{at}em.neurol.med.tohoku.ac.jp

Intractable hiccup and nausea (IHN) was found in eight of 47 cases of relapsing neuromyelitis optica (NMO) (17%) but in none of 130 cases of multiple sclerosis (MS). IHN resolved with methylprednisolone. In six cases, MRI detected linear medullary lesions involving the pericanal region, the area postrema, and the nucleus tractus solitarius. Like long and centrally located myelitis, a linear medullary lesion causing IHN may distinguish NMO from MS.

Supported by the grants from the Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labor and Welfare of Japan.

Disclosure: The authors report no conflicts of interest.

Received February 2, 2005. Accepted in final form July 20, 2005.




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