title: Persistent hiccups and vomiting with multiple cranial nerve palsy in a case of zoster sine herpete.
abstract: A 76-year-old man came to our hospital complaining of hiccups and vomiting lasting for five days. A neurological examination showed dysfunction of cranial nerves V, VII, VIII, IX and X on the left side. Cerebrospinal fluid polymerase chain reaction for varicella zoster virus-DNA was positive. The patient responded well to treatment with intravenous acyclovir and steroids. To the best of our knowledge, this is the first case report of zoster sine herpete presenting with persistent hiccups and vomiting. It is important to keep in mind that herpes zoster can present with symptoms that closely resemble those of intractable hiccups and nausea of neuromyelitis optica. Early detection of the virus is critical for making appropriate treatment decisions.
authors.affiliation: Department of Neurology, National Hospital Organization Okinawa National Hospital, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Natsumi
authors.initials: N
authors.lastname: Fujisaki
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakachi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sueyoshi
authors.forename: Shugo
authors.initials: S
authors.lastname: Suwazono
authors.forename: Masahito
authors.initials: M
authors.lastname: Suehara
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003389:Cranial Nerve Diseases / Q000209:etiology*; D004279:DNA, Viral; D006606:Hiccup / Q000209:etiology*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D014839:Vomiting / Q000209:etiology*; D031368:Zoster Sine Herpete / Q000150:complications* / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir