title: Clinical analysis of neuromyelitis optica presenting as intractable nausea, vomiting and hiccups.
abstract: Vomiting and hiccups can be the manifestations of numerous systemic and neurological illnesses. Intractable nausea, vomiting and hiccups (INH) are reported as possible initial manifestations of neuromyelitis optica (NMO), but not correctly identified. Awareness of these atypical presentations is conducive to NMO early diagnosis and proper treatment to prevent further disability. In this paper, 12 NMO were reported, whose intractable vomiting and hiccups were the sole manifestations of the first attack and other attacks involving spinal cord and optic nerves developed later. All the patients were women and serum aquaporin 4 antibody (AQP4-Ab) of 83% patients was positive. MRI of 50% patients showed T2-weighted imaging/fluid attenuated inversion recovery hyperintensity which were longitudinally extensive transverse myelitis or linear signal changes. Sixty-seven percent of patients had medulla lesions, in which dorsomedial and area postrema were involved.
authors.affiliation: a Department of Neurology, Suzhou Municipal Hospital , Nanjing Medical University , Suzhou , China.
authors.forename: Xuehong
authors.initials: X
authors.lastname: Jin
authors.affiliation: a Department of Neurology, Suzhou Municipal Hospital , Nanjing Medical University , Suzhou , China.
authors.forename: Shaofang
authors.initials: S
authors.lastname: Pei
authors.affiliation: a Department of Neurology, Suzhou Municipal Hospital , Nanjing Medical University , Suzhou , China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: a Department of Neurology, Suzhou Municipal Hospital , Nanjing Medical University , Suzhou , China.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D066193:Cervical Cord / Q000000981:diagnostic imaging; D005260:Female; D006606:Hiccup / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000000981:diagnostic imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D009471:Neuromyelitis Optica / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016896:Treatment Outcome; D014839:Vomiting / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone
keywords: Intractable nausea; hiccups; magnetic resonance examination; neuromyelitis optica; vomiting