Il riflesso chin-hiccup

Il riflesso del singhiozzo provocato dalla stimolazione del mento.

Prof.Tommaso Todisco Primario di Pneumologia.

Respiration 2004;71:104
DOI: 10. 1159/000075661

Chin Stmulation: A Trigger Point for Provoking Acute Hiccups
Tommaso Todisco, Cristina Todisco, Lucio Bruni, Rosario Donato

Pulmonary and Critical Care Unit, Silvestrini Hospital, Section Internal and Cardiovascular Medicine, Department of Internal Medicine, Section of Anatomy, Department of Experimental Medicine and biochemical Science, University of Perugia, Perugia, Italy

Initiation of hiccups by manipulation of the unshaven (24-hour hair growth) chin is a not previously know way to provoke this mysterious malady, wich ceases abruptly upon interruption of chin manipulation. Hiccups caused by irritation of the auricular branch of the vagus nerve have been described in a series of reports with a variety of causes:an ant entering the external auditory meatus;a hair in the external auditory canal: overexpansion of the stomach after eating or excessive drinking; alcohol intake, and sulfonamide administration. The overview of Launois et al. on hiccup pathophysiology in adults did not describe the chin as a trigger point for hiccups, and even in more recent literature it has remained underscribed. We report two middle-aged, healthy men who discovered that by stroking or shaving their unshaven chin they could provoke acute explosive hiccups. The reflex disappeared after local anesthesia of the mental nerve.

Sensory afferents from the skin of the chin project to the intermediate part of the nucleus of the spinal tract of the fifth nerve.Efferents from this nucleus project to the facialnucleus and trigger the blinking reflex. It is possible that, in the cases reported here, afferents from the nucleus of the spinal tracts of the fifth nerve may also project to the medullary reticular formation wich, in turn, recruits the phrenic nucleus and the nucleus ambiguous, responsible for hiccups. These subjects also presented the Arnold’s nerve oto-respiratory reflex bilaterally. Contrary to the claim of Golomb that hiccups could be good for nothing, one may speculate that these two reflexes could be considered primordial defense-like mechanisms. In fact, both the Arnold’s reflex cough and the chin reflex hiccup instantly interrupt respiration and both produce a frightening noise, simultancously protecting the airways and scaring the aggressor.

References:

1 Launois S. Bizec JL, Whitelaw WA Cabane J, Derenne JP: Hiccup in adults: An overview. Eur Respir 1993;6:563-575.

2 Crosby EC, Humprey T, Lauer EW: Correlative Anatomy of the Nervous System. New York, MacMillan, 1962.

3 Todisco T: The oto-respiratory reflex. Respiration 1982;43:354-358.

4 Golomb B: Hiccup for hiccups. Nature 1990;345:774.

5 Gupta D, Verma S, Vishwarkarma SK: Anatomic basis of Arnold’s earcough reflex, Surg Radio Anat 1986;8:217-220.

 

Prof. Tommaso Todisco, Pulmonary and Critical Care Unit Silvestrini Hospital, Via G.Dottori, 1 IT-06132 S.Sisto, Perugia (Italy)Tel. +39075 5288556 Fax +39 075 5286736

QUESTIONARIO

Nome (iniziali)

Cognome (iniziali)

Sesso

Data nascita

Razza

Nazionalità

Attività lavorativa

Fumatore

Non fumatore

Ex fumatore

Notizie cliniche
Asma,bronchite,allergie,,malattie cardiache ,malattie gastrointestinali, reflusso gastro-esofageo, malattie endocrine ,malattie neuro-psichiatriche
malattie otorinolaringoiatriche:

Altre malattie :
Interventi chirurgici:
Altre notizie riguardanti la presenza di riflessi  particolari:
-riflesso OTO-Bronchiale  ed  OTO-respiratorio ( tosse od asma scatenate dalla stimolazione della parete posteriore del meato uditivo esterno):

Storia clinica del riflesso  del singhiozzo

Quando ha  per la prima volta saputo di avere il riflesso del singhiozzo ed in quali condizioni?:

Che cosa lo provoca?:

Il riflesso del singhiozzo si interrompe cessando la stimolazione? Se continua, per quanto tempo?:

Hai notato di avere altri riflessi rari?:

Puoi muovere volontariamente i padiglioni auricolari( come i cani , gatti od i cavalli)?:

Il riflesso è presente anche in altre persone della famiglia?:

La presenza del riflesso ti provoca limitazioni in altre attività (es.durante la rasatura, toccando il mento per caso):

Aggiungi qualsiasi altra notizia che ritieni essere interessante in connessione con l’argomento.

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Prof. Tommaso Todisco


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