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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
References
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