{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:27:25Z","timestamp":1787772445049,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Acute optic neuritis (ON) is caused by variety of complex disorders that can be differentiated with the help of history, radiology, and serology. Identification of nonneurological symptoms that occur before the demyelinating event aids in timely diagnosis and prevention of further neurological attacks. We describe a case of unilateral ON with a history of intractable hiccups, nausea, and vomiting, wherein the possibility of area postrema syndrome (APS) was overlooked until the development of visual symptoms. APS recently identified as a hallmark of neuromyelitis optica spectrum disorder is a rare neurologic cause of gastrointestinal symptoms. This atypical presentation of APS results from autoantibodies directed against the aquaporin-4 rich sites, such as area postrema. This case brings to light the importance of eliciting history of intractable hiccups, nausea, and vomiting in a patient with ON. Despite being a commonly encountered symptom, it may rarely raise a suspicion for neuromyelitis optica.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ojo.ojo_65_21","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T13:49:17Z","timestamp":1716558557000},"page":"366-369","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Intractable hiccups, nausea, and vomiting, an unnerving cause of vision loss"],"prefix":"10.4103","volume":"15","author":[{"given":"Shanmugam Mahesh","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Venkatraman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akkayasamy","family":"Kowsalya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayasri","family":"Narayanamoorthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marappan","family":"Jayasudha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-22-20240908","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/1756285617709723","article-title":"Differential diagnosis of neuromyelitis optica spectrum disorders","volume":"10","author":"Kim","year":"2017","journal-title":"Ther Adv Neurol Disord"},{"key":"R2-22-20240908","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.preteyeres.2013.03.001","article-title":"Optic neuritis in neuromyelitis optica","volume":"36","author":"Levin","year":"2013","journal-title":"Prog Retin Eye Res"},{"key":"R3-22-20240908","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1177\/1352458512472748","article-title":"Utility of aquaporin-4 antibody assay in patients with neuromyelitis optica spectrum disorders","volume":"19","author":"Kim","year":"2013","journal-title":"Mult Scler"},{"key":"R4-22-20240908","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1002\/ana.22121","article-title":"Intractable vomiting as the initial presentation of neuromyelitis optica","volume":"68","author":"Apiwattanakul","year":"2010","journal-title":"Ann Neurol"},{"key":"R5-22-20240908","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1136\/jnnp.2008.145391","article-title":"Intractable hiccup and nausea in neuromyelitis optica with anti-aquaporin-4 antibody: A herald of acute exacerbations","volume":"79","author":"Takahashi","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R6-22-20240908","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/WNO.0b013e318254c62d","article-title":"Magnetic resonance imaging of optic neuritis in patients with neuromyelitis optica versus multiple sclerosis","volume":"32","author":"Khanna","year":"2012","journal-title":"J Neuroophthalmol"},{"key":"R7-22-20240908","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1136\/jnnp.50.5.517","article-title":"A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis: 2. Laboratory results","volume":"50","author":"Compston","year":"1987","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R8-22-20240908","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jns.2017.12.034","article-title":"Comparison of efficacy and tolerability of azathioprine, mycophenolate mofetil, and lower dosages of rituximab among patients with neuromyelitis optica spectrum disorder","volume":"385","author":"Yang","year":"2018","journal-title":"J Neurol Sci"}],"container-title":["Oman Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_65_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:47:07Z","timestamp":1787770027000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_65_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ojo.ojo_65_21","relation":{},"ISSN":["0974-620X"],"issn-type":[{"value":"0974-620X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}