A Case of Intractable Hiccups as Presenting Symptom of Multiple Sclerosis

Intractable hiccups are defined as hiccup persisting for more than 48hours, and these appear in various diseases. A 28-year-old woman admitted due to intractable hiccups without gastroenteral system abnormalities and peripheral nervous systemic involvement. High signal intensity lesion of the medulla oblangata in the tegmental region was detected on T2-weighted MR imaging, which might be a causative etiology. We encountered a rare case developing intractable hic-cups as presenting symptom of 'clinically definte' multiple sclerosis.

Quality of Life in Patients with Parkinson's Disease

BACKGROUND: Quality of life (QoL) has emerged as an important issue to patients with chronic illness. Parkinson's disease (PD) is a chronic neurodegenerative disorder requiring life-time treatment and supportive care, which affects not only physical activity but also cognition, mood, and daily living. The author investigated the QoL of patients with PD and aimed to find factors that have an influence on the QoL. METHODS: One hundred thirty patients with PD were evaluated. The QoL was measured and assessed by the Parkinson's disease quality of life questionnaire (PDQL). The author analyzed demographic and social data and clinical profiles. The Beck Depression Inventory (BDI) and Spielburger's State-Trait Anxiety Inventory were used to evaluate depressive symptoms and anxiety levels. RESULTS: The mean age of onset of parkinsonian symptom was 55.2 +/-10.9 years and the average duration of treatment was 34.7 +/-36.9 months. Patients with high BDI score, low Schwab and England activities of daily living scale (SEADLS) score, high bradykinesia score, progressed Hoehn and Yahr stage, high Unified Parkinson's disease rating scale score, low educational period and high economic state were all correlated with low PDQL scores. Multivariate regression analysis showed that BDI score, bradykinesia score, SEADLS score, and educational period were significantly associated with PDQL score. CONCLUSIONS: In order of magnitude, BDI, bradykinesia, SEADLS and educational period were influenc-ing factors on PDQL. Therefore, to improve the QoL in patients with PD, we should consider not only physical disabili-ty, but also psychological factors, including depressive mood.