hikke (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Basisoplysninger</h2>
<h3>Definition</h3>
<ul>
    <li>Ufrivillige, periodiske kontraktioner af diafragma, stemmeb&aring;nd og samtidige reflektoriske lukninger af glottis</li>
</ul>
<h3>Diagnostisk tankegang </h3>
<ul>
    <li>Kronisk hikke udredes i forhold til aktuelle differentialdiagnoser</li>
    <li>Hikke medieres via en refleksbue involverende n. vagus, n. phrenicus og sympaticus, hjernestammen til central modulering&nbsp;samt efferent signalering til diagfragma og intercostalmuskler</li>
</ul>
<h3>ICPC-2</h3>
<p>[ICPC]</p>
<h3>ICD-10</h3>
<p>[ICD10]</p>
<h2>&Aring;rsager&nbsp;</h2>
<h3>Kortvarig hikke (minutter)</h3>
<ul>
    <li>Kan udl&oslash;ses af hurtig madindtagelse, hoste, latter, luft i maven, hiatus hernie, kolde drikke, alkohol (is&aelig;r abstinens), stress eller operation</li>
</ul>
<h3>Langvarig hikke (op til 48 timer og sj&aelig;ldent mange &aring;r)</h3>
<ul>
    <li>Kan skyldes
    <ul>
        <li>Kemoterapeutika </li>
        <li>L&aelig;sion i centralnervesystemet - <a href="~/link.aspx?_id=A93B87FDC0A24FA68403088B8A468DE3&amp;_z=z">apopleksi</a>, <a href="~/link.aspx?_id=F3A8C1841AE940BEB4FC3C18F07ACCB8&amp;_z=z">encefalitis</a>,&nbsp;<a href="~/link.aspx?_id=BF43C438F520402F9003F17299AD1C05&amp;_z=z">multipel sklerose</a>&nbsp;og andre demyeliniserende sygdomme, <a href="~/link.aspx?_id=90ADCE762F78496B8F98C2CF4F37E766&amp;_z=z">svulst</a></li>
        <li>Irritation af n. phrenicus og diafragma fra thoraxsiden - <a href="~/link.aspx?_id=671F9ADAC6CB4DD0AA7B031F605ADABF&amp;_z=z">pleuritis</a>, lymfeknuder i mediastinum, <a href="~/link.aspx?_id=38DFE0F1BE404EEE8A5E656FC64F98D1&amp;_z=z">pericarditis</a>, <a href="~/link.aspx?_id=C0137DD2232646F6AD549B643A06B77F&amp;_z=z">pneumoni</a>, <a href="~/link.aspx?_id=74939EBF4A694B359A96B1E33A94FC50&amp;_z=z">AMI</a>, <a href="~/link.aspx?_id=5934DFE853AA4B578E7FCD704A8C297C&amp;_z=z">hiatus hernie</a> </li>
        <li>Irritation af diafragma fra abdomen - subfrenisk absces, ventrikelretention, ventrikel udvidelse,&nbsp;kr&aelig;ft, <a href="~/link.aspx?_id=38813CBC362A43668C1193AFB841568B&amp;_z=z">galdevejssygdom</a> </li>
        <li>Irritation af n. phrenicus i halsregionen - <a href="~/link.aspx?_id=6F8C67265AD4418CBB1BA4514AE6EA53&amp;_z=z">struma</a>, <a href="~/link.aspx?_id=25FC45605F1346C39C26A9873007A244&amp;_z=z">lymfomer</a></li>
    </ul>
    </li>
</ul>
<h2>Tiltag og r&aring;d</h2>
<h3>R&aring;d</h3>
<ul>
    <li>Ofte er hikken selvlimiterende </li>
    <li>Der findes mange "husr&aring;d", hvis effekt er usikker.&nbsp;Ved&nbsp;pludselig forskr&aelig;kkelse kan vagus stimuleres. Afbrydelse af vejrtr&aelig;kning og stimulation af &oslash;sofagus ved. f.eks. at holde vejret, st&aring; godt fremoverb&oslash;jet og drikke et glas vand fra glassets bagre kant er ogs&aring; foresl&aring;et</li>
    <li>I en systematisk gennemgang af litteraturen for evidensbaseret behandling, herunder effekt af akupunktur,&nbsp;fandtes ingen effektiv behandling<a title="Moretto,EN et al. Interventions for treating persistent and intractable hiccups in adults. Cochrane Database Syst rev 2013;1: CD008768" href="%20" data-type="other-reference" data-value="Moretto,EN et al. Interventions for treating persistent and intractable hiccups in adults. Cochrane Database Syst rev 2013;1: CD008768" data-url="http://www.ncbi.nlm.nih.gov/pubmed/23440833">1</a></li>
    <li>Trods manglende evidens og baseret p&aring; case-reports, kan langvarig hikke fors&oslash;ges behandlet med<br>
    <ul>
        <li>[DliActiveSubstance;5348;Gabapentin]&nbsp;300 mg x 3</li>
        <li>[DliActiveSubstance;5753;Baclofen]&nbsp;(tbl. 5 mg x 3 evt. stigende til 20 mg x 3)</li>
        <li>[DliActiveSubstance;6145;Metoclopramide]&nbsp;10 mg x 3 daglig</li>
    </ul>
    </li>
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