Cyclical vomiting syndrome (CVS)

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Cyclical vomiting syndrome (CVS). This is a chronic disorder. There are sudden episodes of nausea and vomiting. Fully referenced neurology checklist.

Definition

  • This is a chronic disorder
  • There are sudden episodes of nausea and vomiting
  • The episodes last 1–5 days
  • The frequency is about 9 times a year in children and 14 in adults
  • It may be related to dysfunction in the insular cortex

Diagnostic criteria

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Triggers

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Prodromal symptoms

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Associated features

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Differential diagnosis

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Treatment

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Features of migraine-associated CVS

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Acute treatment of migraine-associated CVS

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Preventative treatment of migraine-associated CVS

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References

  1. Hayes WJ, VanGilder D, Berendse J, Lemon MD, Kappes JA. Cyclic vomiting syndrome: diagnostic approach and current management strategies. Clin Exp Gastroenterol 2018; 11:77-84.
  2. Ellingsen DM, Garcia RG, Lee J, et al. Cyclic vomiting syndrome is characterized by altered functional brain connectivity of the insular cortex: a cross-comparison with migraine and healthy adults. Neurogastroenterol Motil 2017; 29:10.1111/nmo.13004.
  3. Li BU, Murray RD, Heitlinger LA, Robbins JL, Hayes JR. Is cyclic vomiting syndrome related to migraine? J Pediatr 1999; 134:567-572.
  4. Ferretti A, Fanfoni C, Vadrucci F, et al. Cyclic vomiting syndrome in pediatric population: characteristics and prophylactic response to cyproheptadine. Minerva Pediatr (Torino) 2024 (Online ahead of print).
  5. Hayes WJ, Weisensee LA, Kappes JA, Dalton SM, Lemon MD. Onabotulinumtoxin A injections for the treatment of cyclic vomiting syndrome. Pharmacotherapy 2015; 35:e51-e55.
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