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Last Updated: Tuesday, 29 June, 2004, 10:18 GMT 11:18 UK
Op cures year-long hiccups bout
The surgery was relatively simple
Surgeons have succeeded in curing a man who had non-stop hiccups for a year.

The hiccup attack started after Shane Shafer, 50, from Texas, had a stroke.

He is believed to have become the first person in the world to undergo surgery to fit a device to control stimulation of a major nerve.

When the implant was activated following the surgery at Louisiana State University, Mr Shafer's hiccups stopped, and have not as yet returned.

We're excited about our short-term success and are hopeful that we will offer Mr Shafer long-term relief
Dr Bryan Payne
Before surgery he required 10 injections a day of a painkiller to bring some relief, the only other alternative being to make himself vomit.

Hiccups are sudden, involuntary contractions of the diaphragm, a sheet of muscle which separates the chest cavity from the abdomen, and which plays a key role in the breathing process.

As the muscle contracts repeatedly, the opening between the vocal cords snaps shut to check the inflow of air and makes the hiccup sound.

In many cases hiccups are linked to irritation of the nerves that extend from the neck to the chest.

In Mr Shafer's case, surgeons Dr Bryan Payne and Dr Robert Tiel suspected his problem was linked to an irregularity with the vagus nerve, brought on by the stroke.

They believed the stroke may have triggered an abnormal connection between cells in the brain associated with the vagus nerve, and other cell groups associated with the phrenic nerve which supplies the diaphragm.

Electrical impulses

They attempted to correct the problem using a device called a Vagus Nerve Stimulator (VNS).

This uses electrical impulses delivered by a generator implanted in the chest to two tiny leads wrapped around the nerve in the neck.

The dose of stimulation is programmed by a doctor, and delivered automatically.

The technique has already been successfully used to treat seizures that have failed to respond to other types of therapy.

The surgery, which can easily be reversed, requires just two small incisions.

Dr Payne said: "Mr Shafer had a stroke that caused severe hiccups of both halves of his diaphragm.

"We wanted to break the cycle of connection associated with hiccups in the same way that VNS therapy disrupts the circuit in seizures.

"We're excited about our short-term success and are hopeful that we will offer Mr Shafer long-term relief."

Hiccups serve no purpose and usually end naturally without any need for medical intervention.

Prolonged attacks can cause significant illness and even death.

Why we hiccup
06 Feb 03  |  Health

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