singultation


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sin·gul·ta·tion

(sing-gŭl-tā'shŭn),
Hiccupping. See: hiccup.
[L. singulto, pp. -atus, to hiccup]
An abrupt inspiratory muscle contraction, followed within 35 msec by glottic closure; the hiccup center is in the spinal cord between C3 and C5; an afferent impulse is carried by the vagus and phrenic nerves and thoracic sympathetic chain; the efferent impulse is carried by the phrenic nerve with branches to the glottis and accessory respiratory muscles
Aetiology Idiopathic, psychogenic, abdominal disease—gastric distension, gastrointestinal hemorrhage, bowel obstruction—esophagospasm or inflammation including hepatitis, peritonitis, gastritis, enteritis, appendicitis, pancreatitis, abrupt temperature change, alcohol, inferior wall MI, irritation of tympanic membrane, metabolic derangements—azotemia, hyponatraemia, uremia—diaphragmatic irritants, diseases of chest wall, lung, and heart—mediastinitis, tumours, aortic aneurysms, subphrenic abcesses, pericarditis—foreign bodies, excess smoking, excitement or stress, toxins, drugs—general anesthesia, barbiturates, diazepam, alpha-methyldopa—pneumonia, herpes zoster, central and peripheral nervous system disease—encephalitis, tumours, meningitis, brainstem infarcts, phrenic nerve compression, cervical cord lesions; intractable hiccupping may result in inability to eat or sleep, arrhythmias or reflux oesophagitis, or may be compatible with a normal life. The most recalcitrant case of hypersingultation occurred in an American pig farmer, which began in 1922, and continued to 1987
Management No therapy is consistently effective.Chlorpromazine, a dopaminergic blocker, and diphenhydramine may be as effective as—and more dignified than—standing on one’s head and other ‘folk’ maneuvers; other dopaminergic blockers include haloperidol, metoclopramide and apomorphine; rare cases respond to amantidine or amitriptyline, carbamazepine, nifedipine, baclofen, ketamine, phenytoin and lidocaine, with fewer side effects

singultation

(sĭng″gŭl-tā′shŭn) [L. singultus, a hiccup]
Hiccupping.