[Hiccup treated by administration of intranasal vinegar]

A three-year old girl, who had severe cerebral palsy, severe mental retardation, and symptomatic epilepsy, was suffering from intractable hiccup that lasted for more than an hour since she was 2 years and 10 months old when she undertook tracheotomy and laryngotracheal separation. Sometimes this intractable hiccup was followed by respiratory arrest. Although the hiccup was resistant to conventional medications, the nose drops of small amount of vinegar showed a favorable effect on the hiccup. Intranasal vinegar might stimulate dorsal wall of nasopharynx where the pharyngeal branch of the glossopharyngeal nerve, which is thought as an afferent of the reflex arch of hiccup, is distributed. The administration of intranasal vinegar is a safe and handy method to stimulate dorsal wall of nasopharynx. We believe that intranasal vinegar administration could be a useful nonpharmacologic therapy to cease intractable hiccup.