Abstract：
METHODS: A 52-year-old man developed a cerebral infarction from the right middle cerebral artery occlusion, and the infarction extensively damaged the right insula. Three months after the onset of the cerebral infarction, persistent hiccups appeared, occurring during sleep. The thoracic and abdominal cavities showed no lesions; hence, the hiccups were considered to be caused by central nervous system dysfunction. Administration of metoclopramide, chlorpromazine, and diazepam were ineffective, while levetiracetam had a partial effect. Combining perampanel with baclofen finally suppressed the symptoms.
CONCLUSIONS: Lesions at the right insula impair respiratory reflex and may present with hiccups as a symptom of respiratory reflex disinhibition. Here, we review similar cases of treatment-resistant hiccups, as well as perampanel and baclofen efficacy in myoclonus cases.
CONCLUSIONS: Our patient\'s case suggested that perampanel with baclofen may be effective for myoclonus due to respiratory reflex disinhibition and can be used to treat hiccups derived from cerebral infarctions.
CONCLUSIONS: Lesions at the right insula impair respiratory reflex and may present with hiccups as a symptom of respiratory reflex disinhibition. Here, we review similar cases of treatment-resistant hiccups, as well as perampanel and baclofen efficacy in myoclonus cases.
CONCLUSIONS: Our patient\'s case suggested that perampanel with baclofen may be effective for myoclonus due to respiratory reflex disinhibition and can be used to treat hiccups derived from cerebral infarctions.
摘要：
方法：一名52岁男子因右侧大脑中动脉闭塞而发展为脑梗塞，梗塞严重损害了右岛。脑梗塞发病三个月后，持续的打嗝出现，发生在睡眠期间。胸腔和腹腔没有显示病变；因此，打嗝被认为是由中枢神经系统功能障碍引起的。服用甲氧氯普胺，氯丙嗪,地西泮无效,而左乙拉西坦有部分作用。将perampanel与巴氯芬联合使用最终抑制了症状。
结论：右侧脑岛病变损害呼吸反射，并可能表现为呼吸反射抑制的症状。这里,我们回顾了类似的治疗抵抗的打嗝病例，以及帕帕内和巴氯芬在肌阵挛症病例中的疗效。
结论：我们患者的病例表明，巴氯芬联合帕拉尼可能对呼吸反射抑制引起的肌阵挛症有效，可用于治疗脑梗塞引起的打嗝。
结论：右侧脑岛病变损害呼吸反射，并可能表现为呼吸反射抑制的症状。这里,我们回顾了类似的治疗抵抗的打嗝病例，以及帕帕内和巴氯芬在肌阵挛症病例中的疗效。
结论：我们患者的病例表明，巴氯芬联合帕拉尼可能对呼吸反射抑制引起的肌阵挛症有效，可用于治疗脑梗塞引起的打嗝。
