Cyclical Vomiting and Abdominal Migraines

Cyclic vomiting is an entity of recurrent, severe vomiting over two to three days several times a week, and during the days in between the child is well. Apparently the vomiting can be precipitated by stress or excitement. Beforehand, there may be nausea, lethargy, headache or fever. The cause is unclear, although it is thought that it might be similar to migraines (and thus the episodes are called abdominal migraines). A workup needs to be performed to rule out other potential causes of vomiting (blood work, radiologic studies including MRI of the brain or endoscopy). The pediatrician should be able to do a careful history and physical examination and decide on some preliminary studies. However, a pediatric gastroenterologist or pediatric neurologist might need to be involved. Make sure the child does not get dehydrated during episodes. Prevention has been discussed using anti-migraine drugs. Cyclic vomiting is a pediatric entity and would not be specific for CdLS; it could occur in anyone. I have not heard of any patients with CdLS experiencing this previously.

TK 7-13-10