LSUHSC neurosurgical team discovers novel therapy for intractable hiccups

New Orleans--Dr. Bryan R. Payne, and Dr. Robert Tiel, neurosurgeons at LSU Health Sciences Center in New Orleans have discovered a new approach to treating medically intractable hiccups. They implanted a Vagus Nerve Stimulator in a Texas man to stop the hiccups which have severely disrupted Shane Shafer's life following a stroke he had two years ago. This is the first reported case of its kind. When Dr. Payne activated the implant following the surgery, Shafer's hiccups stopped, and they have not as yet returned.

Although hiccups are a normal occurrence, they serve no useful purpose. Hiccups are normally self-limiting. In some cases, however, hiccups don't go away, and these prolonged attacks can cause significant illness and even death. When the attack lasts longer than a month, the hiccups are termed intractable. Although more than a hundred causes have been describedeverything from hysteria to trauma and malignancies--sometimes hiccups are caused by irritation of the vagus nerve. The vagus nerve, measuring about 22 inches, is the longest cranial nerve, wandering throughout the upper body. It is one of the body's primary communication pathways from the brain to other organs, and it contains few if any pain fibers. Mr. Shafer's hiccups were likely due to an aberrant connection or cycle between the groups of brain cells associated with the vagus nerve and those of the phrenic nerve which supplies the diaphragm caused by his stroke.

A vagus nerve stimulator uses electrical impulses delivered by a programmable generator implanted in the chest to two tiny leads wrapping around the vagus nerve in the neck to disrupt faulty nerve communication. The "dose" of stimulation, programmed by the physician, is automatically delivered. VNS therapy has been effective in controlling medically refractory seizures, and an FDA Advisory panel recently recommended approval of VNS therapy as an adjunct treatment for non-responsive depression as well. The minimally invasive pro

Contact: Leslie Capo
Louisiana State University Health Science Center

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