UMEM Educational Pearls

Title: Cyclic Vomiting

Posted: 10/23/2009 by Rose Chasm, MD (Updated: 11/22/2024)
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characterized by paroxysms of severe vomiting without apparent cause separated by periods of complete health
typically begins between 3 and 7 years of age
family or patient history of migraine or irritable bowel syndrome often noted
intentse vomiting with lethargy, fever, and headache preceding the onset of emesis
episodes last up to 48 hours (but may last up to one week) with 4-12 episodes per hour, and end suddenly often after sleep
two thirds of children become so dehydrated they require intravenous fluids
most patients have stereotypic patterns of onset and triggering events
rapid treatment with IVF and glucose, along with migraine treatments such as cyproheptadine, propanolol, and TCA's
antiemetics often not effective

Forbes D, Withers G. Prophylactic therapy in cyclic vomiting. J Pediatr Gastroenterol Nutr. 1995;21:S57-S59

Symon DN, Russell G. The relationship between cyclic vomiting syndrome and abdominal migraine. J pediatr Gastroenterol Nutr. 1995:21:S42-S43