Cyclic Vomiting Syndrome in Infants and Children: A Clinical Follow-Up Study

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• 作者：Toshiyuki Hikita ; MD ; ^{t-hikita@ra2.so-net.ne.jp" class="auth_mail" title="E-mail the corresponding author} ; Hiroko Kodama ; MD ; Kaori Ogita ; MD ; Sono Kaneko ; MD ; Natsue Nakamoto ; MD ; Masakazu Mimaki ; MD
• 关键词：International Headache Classification ; migraine ; adrenocorticotropic hormone ; antidiuretic hormone ; prophylactic therapy
• 刊名：Pediatric Neurology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：57
• 期：Complete
• 页码：29-33
• 全文大小：300 K

文摘

Cyclic vomiting syndrome is characterized by recurrent vomiting that is associated with increased adrenocorticotropic hormone and antidiuretic hormone levels during cyclic vomiting syndrome attacks. However, both prognosis and treatment remain unclear. We therefore evaluated the clinical features, prognosis, and effectiveness of the prophylaxis of cyclic vomiting syndrome as well as the relationship between symptoms and adrenocorticotropic hormone/antidiuretic hormone levels.

Methods

We included 31 patients with cyclic vomiting syndrome who were admitted to Teikyo University between 1996 and 2008. All patients were diagnosed with cyclic vomiting syndrome based on the criteria of the second edition of the International Headache Classification. The patients (25 of 31) were followed until 2013.

Results

The median overall duration of the disorder was 66 (3-179) months. Follow-up was completed for 25 patients with cyclic vomiting syndrome, of whom 44% (n = 11) developed migraine. Valproic acid, valproic acid with phenobarbital, phenobarbital, and amitriptyline were effective in nine, four, three, and one patients, respectively. Abnormally high adrenocorticotropic hormone (n = 17) and antidiuretic hormone (n = 18) levels were found among the 25 patients for whom follow-up data were available. The following correlations were significant: attack duration and adrenocorticotropic hormone levels (correlation coefficient: 0.5153, P = 0.0084) and attack duration and antidiuretic hormone levels (correlation coefficient: 0.5666, P = 0.0031). Antidiuretic hormone levels in patients with bilious vomiting were higher than in those without bilious vomiting (P = 0.048).

Conclusions

Most patients with cyclic vomiting syndrome recovered completely and benefited from prophylactic therapy, although half of them developed migraines.