A young man’s persistent hiccups were a sign of a far scarier health problem, according to a recent case report from doctors in India. The man turned out to have an aggressive brain tumour, one that had started to cause pressure on his brain. Once he began receiving cancer treatment, though, his hiccups went away.
By the time the man saw a doctor, he had been experiencing unceasing hiccups for about four months but otherwise seemed fine. Eventually, though, he developed a severe headache and projectile vomiting. Most of his medical exams revealed nothing out of the ordinary, until his brain was scanned. There, doctors spotted a diffuse pontine glioma, a tumour found in an area of the brain stem known as the pons. The tumour was also found alongside a mild form of hydrocephalus, a condition in which excess fluid builds up in the brain, often squishing it in the process.
The strange case was detailed last week in BMJ Case Reports.
Hiccups are caused by involuntary contractions of the diaphragm, a thin muscle at the base of the chest that primarily helps us breathe. There are many potential triggers for hiccups, including eating too fast, drinking carbonated beverages, taking certain medications, or even a bout of stress. But as the authors of the case report note, the vast majority of hiccup episodes are benign and short-lasting. When hiccups keep happening, though, they can be a sign of something more serious, including neurological disorders.
Indeed, there have been reports in the past of hiccups being linked to brain tumours. In these cases, it’s often believed that the tumour somehow irritates the phrenic nerve, a nerve that starts from our neck and help regulates the diaphragm.
What made this case unusual is that the man’s hiccups were the only sign of something wrong for months, the doctors noted. But once the tumour was discovered, the patient underwent neurosurgery and radiation therapy. And about a month after the radiation started, his hiccups had “subsided considerably.”
To be clear, chronic hiccups are thankfully rare, and even rarer are hiccups caused by brain tumours. They may be a bit more common for advanced cancer patients, though these include cancers outside of the brain and can be linked to the treatments people get rather than the cancer itself. Some of the many other known causes of chronic hiccups include hernias, gastroesophageal reflex disease, and surgery complications.
Hiccups are an annoying fact of life, but if someone starts complaining of persistent and intractable hiccups, the doctors wrote, “it’s crucial that these patients undergo a detailed evaluation as a timely diagnosis of underlying medical pathologies can help prevent further complications.”