Epileptic diaphragm myoclonus

Abstract

Persistent singultus is a rare condition, occasionally caused by central nervous system abnormalities. We report a six-year-old girl with daily hiccup events. A polygraphic recording capturing nine singultus episodes showed myoclonia of the diaphragm lasting 104-131 milliseconds, time-locked to bilateral, synchronous, double-spike-and-wave discharges, maximum at frontal contacts. The initial EEG spikes preceded the onset of EMG discharges by 56-64 (median: 59) milliseconds. This is the first description of an epileptic patient with hiccups as the main seizure manifestation. The electrophysiological findings suggest a primary generalised form of epilepsy and polysynaptic impulse transmission. [Published with video sequences].