Treatment of resistant idiopathic hiccups with pulse radio frequency on phrenic nerve and gabapentin: A case report.

Hiccups affect life quality, career and family life when they become persistent. We present here a 54-year-old man who worked as a mason and a blacksmith with hiccups complaint for nearly one and a half years. In this period, he was admitted to emergency service ten times with fainting or almost fainting, cold sweating and hand stretching complaints. The patient expressed that he frequently threw up when he had hiccups and his social life was negatively affected. He reported that he was treated with baclofen, esomeprazole and hyoscine-n-butyl bromur without relief. He used escitalopram and chlorpromazine for a short time and quit because they negatively affected his sleeping. As he did not have any relief from medications, he refused any oral medical therapy including gabapentin and started to seek remedy from paramedical treatments resulted with no benefit. The patient was referred to algology department and an intervention on phrenic nerve with pulse radio frequency (8 minutes, 45 Volts, 20 milliseconds wavelength) was performed. Symptoms stopped immediately after the procedure but one week later, although the patient reported a significant decline in symptoms he still had hiccups. The patient was offered oral medical therapy again. With considerable relief from symptoms, the patient accepted oral therapy this time. Gabapentin 300 mg bid was prescribed. The symptoms were completely recovered and the patient reported no hiccups after 30 days of Gabapentin administration. Our case suggests that administration of gabapentin after pulsed radiofrequency might be effective for the treatment of persistent hiccups.