My grandfather and I never met because he died before I was born. But my father was there at the hospital and watched his father’s passing. My grandfather served in World War 1 because I saw a picture of him dressed in a uniform. That uniform was his only remembrance. Good chance he had a brain injury that showed up later. More on that next in this blog.
And what was the reason my grandfather died? Hiccups!
Singultus, otherwise known as hiccups, is common, usually lasts only a few minutes, and may be brought on by a TBI (traumatic brain injury). While most people have mild hiccups lasting less than 48 hours, brain injuries are often associated with:
- Persistent Hiccups: Lasting more than 48 hours
- Intractable Hiccups: Lasting for weeks, sometimes even months
If hiccups persist, it can be highly bothersome, ultimately interfering with sleep and leading to depression and physical exhaustion. Hiccups, for example, can be brought on by gastric reflux, alcohol, cigarette smoke, emotional disturbances like not interacting socially with others, or excessive fear or anxiety, and neurological diseases.
The “Hiccup Center” is in the brain, involving the vagus nerve, the phrenic nerve, and the brainstem. When the brainstem is damaged due to trauma, stroke, or a tumor, the “turn-off switch” for this reflex can breakdown.
Here’s an example:
These lesions, an area of abnormal, damaged, or diseased tissue, such as a wound, ulcer, or skin mark, which can occur on the skin, in blood vessels, or in organs like the brain, often appear as “mulberries” on the MRI.
They can cause severe neurological symptoms, including incurable hiccups, which swallowing difficulties, breathing issues, or cranial nerve abnormalities because of their critical location. While sometimes dormant, these malformations can bleed and cause sudden neurological effects later.
Simple maneuvers first include breath hold, cold water, or sip of sugar and may help with brief episodes. The important thing to keep in mind is, hiccups are more worse for brain injured people. Hiccups with breathing difficulty, altered consciousness, new neurologic losses, signs of sepsis or aspiration, or hiccups lasting more than 48 hours without clear reasons are significant.
It isn’t just that they are worse in terms of discomfort. They are more often a symptom of the injury itself and can be much harder to end. In the normal population with not a brain issue in sight, hiccups last a few minutes. In the brain-injured, they can become intractable, in you allow it to.Â
My grandfather had persistent or intractable hiccups, depending how long the hiccups were lasting. But either way, they’re dangerous, especially for the brain injured like me.
Having done this research, if I had hiccups that lasted only a day, off to the doctor I go. Pronto!
