Table 1.

Causes of persistent hiccups

Central nervous system disorders	Vascular
	Ischaemic/haemorrhagic stroke, AV malformations, temporal arteritis Infections
	Encephalitis, meningitis, brain abscess, neurosyphilis, subphrenic abscess Structural
	Head trauma, intracranial neoplasms, brainstem neoplasms, multiple sclerosis, syringomyelia, hydrocephalus
Vagus and phrenic nerve irritation	Goitre, pharyngitis, laryngitis, hair or foreign-body irritation of tympanic membrane, neck cyst or other tumour
Gastrointestinal disorders	Gastric distention, gastritis, peptic ulcer disease, pancreatitis, pancreatic cancer, gastric carcinoma, abdominal abscesses, gallbladder disease, inflammatory bowel disease, hepatitis, aerophagia, oesophageal distention, oesophagitis, bowel obstruction
Thoracic disorders	Enlarged lymph nodes secondary to infection or neoplasm, pneumonia, empyema, bronchitis, asthma, pleuritis, aortic aneurysm, mediastinitis, mediastinal tumours, chest trauma, pulmonary embolism
Cardiovascular disorders	Myocardial infarction, pericarditis
Toxic–metabolic	Alcohol	Diabetes mellitus
	Herpes zoster	Hypocalcaemia
	Hypocapnia	Hyponatraemia
	Influenza	Malaria
	Tuberculosis	Uraemia
Postoperative	General anaesthesia	Gastric distention
	Intubation (stimulation of glottis)	Traction on viscera
	Neck extension (stretching phrenic nerve roots)
Drugs	Alpha methyldopa	Dexamethasone
	Short-acting barbituates	Diazepam
	Chemotherapeutic agents (for example, carboplatin)
Psychogenic	Anorexia nervosa	Malingering
	Conversion reaction	Schizophrenia
	Excitement	Stress