Faculty Bibliography

Hiccups are a rare manifestation of Lateral Medullary Infarction (LMI). Strokes produce numerous complications, hiccup manifestations are limited in reviewing literatures. Diagnoses of LMIs have been documented predominately by use of MRIs. There have been attempts to make clinical with MRI correlations in patients with LMI, studies with a large number of patients are uncommon among subjects with this etiology. Previous literatures have attempted to investigate anatomical lesions in patients with LMI suffering from hiccups by using imaging. Initial signs are usually headache, vertigo, dizziness or gait ataxia, whereas sensory symptoms consisting of dysphagia, hoarseness and hiccups usually occurred in the latter aspect. Hiccups in LMI are not fully understood and has been insufficiently studied. We describe a case of a man in his sixties with a constant occipital headache lasting 12 days associated with nausea and vomiting prior to admission to acute hospital. There was no history of exposure to any prescription or recreational drugs prior to presentation. The day after admission, he presented with intractable hiccups. Treatment with chlorpromazine (Thorazine) was unsuccessful, hiccups improved after initiation of baclofen and physical therapy. This case suggests that physical therapy may be a valuable aspect for refractory hiccups in conjunction with pharmacological management

Amyotrophic lateral sclerosis is caused by selective degeneration of motor neurons in the brain and spinal cord. There are still no other effective therapies 10 years after the approval of riluzole for the treatment of amyotrophic lateral sclerosis, but advances in drug development and screening are substantially increasing the number of potential therapeutic agents. This review provides an overview of clinical trial methodology in amyotrophic lateral sclerosis followed by a systematic evaluation of drugs that are presently in Phase I, II and III clinical trials. There is an emphasis on the scientific evidence supporting the selection of each drug being tested, as well as on trial design