• 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