Indian man’s four-month bout of HICCUPS ‘were triggered by a brain tumour’

An Indian man’s four-month bout of hiccups may have been triggered by a brain tumour, doctors believe.

The unidentified man, in his early 30s, sought medical treatment for a headache which had caused him agony for over a fortnight.

He also complained of projectile vomiting up to three times a day, according to a case report of his illness.

Doctors in Rishikesh, situated in the Himalayan foothills, also heard how the man’s health began to deteriorate four months earlier, when he began to suffer frequent hiccups.

His hiccups eventually became ‘continuous’, affecting both his sleeping and eating patterns. 

Brain scans were conducted to get to the bottom of his mystery illness.   

Results revealed he had a diffuse intrinsic pontine glioma, a highly aggressive and difficult to treat type of brain tumour. 

The man’s hiccups began to subside after beginning treatment for his cancer, it was revealed in in the journal BMJ Case Reports.

Experts theorised the tumour was affecting the part of the brainstem responsible for controlling the nerves and muscles that normally provoke a hiccupping response. 

Dr Nagasubramanyam Vempalli, of the All India Institute of Medical Sciences, wrote the medical report.   

The man told the A&E medics that he had asked doctors for help with the hiccupping previously, but to no avail. 

After a series of blood tests and a physical exam prompted no immediate answers, medics decided to have the man undergo a CT scan. 

They found a lesion within his brain, with medics then getting the man to undergo a more detailed MRI scan. 

This revealed a mass of tissue indicative of a pontine glioma, a type of brain tumour that grows on the brainstem, the part that connects the organ to the spine, as well as internal bleeding within the brain itself.

Pontine gliomas are impossible to remove surgically due to how interconnected they are with the actual brainstem.

The man was sent for an operation where surgeons cut into his brain to normalise the pressure within his skull, which was resulting from a build-up of fluid in the brain.

After eight days recovery the man underwent a six-week course of radiotherapy in an attempt to kill the tumour.

‘The patient’s hiccups began to resolve after the initiation of radiotherapy and after 1 month of radiotherapy, the patient’s hiccups had subsided considerably,’ Dr Vempalli said. 

The case report does not detail exactly when this case occurred but the man did eventually die, though it is unclear if this was due to the cancer. 

While continuous hiccupping has been observed in brain cancers before the authors note that is is rare for hiccups to be the sole symptom of this kind of tumour.

Dr Vempalli added the case demonstrated the importance of clinicians identifying the causes of continuous hiccupping in a timely manner to ensure a patient does not suffer further complications. 

The NHS advises people to speak to a GP if they have had hiccups for over 48 hours.