Novel Use of Baclofen in Cancer Patients for the Treatment of Hiccups

Abstract

A hiccup is a result of an involuntary, intermittent spasmodic contraction of the diaphragm and the inspiratory intercostal muscles, resulting in a sudden inspiration and ends with an abrupt closure of the glottis.We experienced the successful use of baclofen for the treatment of hiccups in 2 cancer patients in an inpatient rehabilitation unit of a tertiary cancer centre.One of them was a 22-year-old male with a history of neurofi bromatosis type 2 with numerous resections for various tumours including a right vestibular schwannoma and a foramen magnum meningioma.He last underwent resection of 4 intramedullary cervical ependymomas with associated syrinx (Fig. 1).During his postoperative recovery, he developed acute hiccups.This was resolved after 2 doses of oral baclofen of 5 mg each, 6 hours apart.A lower dosage of baclofen was prescribed as he was at risk of sedation from baclofen.The other patient is a 72-year-old male with concomitant rectal and prostate cancer who underwent abdominal and pelvic surgery that involved extensive resection and reconstruction.He suffered a stroke postoperatively.He also experienced abdominal bloating associated with hiccups that resolved with 2 doses of oral baclofen of 10 mg each, 6 hours apart.A higher dosage was prescribed as he was further out from the stroke, with no cognitive defi cits.Both patients did not have prior nonpharmacological treatment and remained symptom free after discontinuation of baclofen.