Cyclical vomiting syndrome is accepted as a migraine syndrome from childhood by the International Headache Society. The criteria for diagnosis according to The Migraine Trust (2019) is:
- A. At least five attacks overall fulfilling criteria B and C;
- B. Episodic attacks, stereotypical in the individual patient, of intense nausea and vomiting, lasting one hour to five days;
- C. Vomiting during attacks occurs at least four times per hour for at least one hour;
- D. Symptom-free between attacks;
- E. Not attributed to another disorder.
- History and physical examination do not show signs of gastrointestinal disease.
Migraine medications can sometimes help stop or even prevent cyclic vomiting episodes. These meds may be recommended for patients with frequent and long lasting symptoms and even patients with family history of migraines. Treatment usually focuses on controlling the signs and symptoms. Prescriptions may include: anti-nausea medications, pain-relieving medications, anti-reflux medications, antidepressants and anti-seizure medications. IV fluids are often necessary to prevent dehydration. Treatment is individualized based on severity, duration or presence of complications.
If you are experiencing CVS with no evidence of gastrointestinal disease, you may be having migraines, which require treatment by a headache specialist. At MCHN, we provide IV hydration and medications to treat CVS.
Tanesha Reynolds, DNP, FNP-BC, Certified in Headache Medicine