TEXTBOOKS
Rudolph CR, Rudolph AM, Lister GE, First LR and Gershon AA. Rudolph’s Pediatrics. 22nd ed. New York, NY:McGraw Hill; 2011:1372-1375.
Li BUK, Adams K, Howard J. Cyclic Vomiting Syndrome. NORD Guide to Rare Disorders. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:525-526.
JOURNAL ARTICLES
Hejazi RA, McCallum RW. Cyclic vomiting syndrome: treatment options. Exp Brain Res. 2014 Aug;232(8):2549-52. doi: 10.1007/s00221-014-3989-7. Epub 2014 May 28.
Hejazi RA, McCallum RW.Review article: cyclic vomiting syndrome in adults–rediscovering and redefining an old entity. Aliment Pharmacol Ther. 2011 Aug;34(3):263-73. doi: 10.1111/j.1365-2036.2011.04721.x. Epub 2011 Jun 12.
Boles RG (2011): High degree of efficacy in the treatment of cyclic vomiting syndrome with combined co-enzyme Q10, L-carnitine and amitriptyline, a case series. BMC Neurol. 2011;11:102.
Boles RG, Lovett-Barr MR, Preston A, Li BU, Adams K. Treatment of cyclic vomiting syndrome with co-enzyme Q10 and amitriptyline, a retrospective study. BMC Neurol. 2010;10:10.
Hejazi RA, Reddymasu SC, Namin F, Lavenbarg T, Foran P, McCallum RW. Efficacy of tricyclic antidepressant therapy in adults with cyclic vomiting syndrome: a two-year follow-up study. J Clin Gastroenterol. 2010 Jan;44(1):18-21. doi: 10.1097/MCG.0b013e3181ac6489.
Venkatesan T, Tarbell S, Adams K, McKanry J, Barribeau T, Beckmann K, Hogan WJ, Kumar N, Li BUK. A survey of emergency department use in patients with cyclic vomiting syndrome. BMC Emergency Medicine. 2010 Feb 24;10:4.
Abell T, Adams K, Boles RG … Li BUK … Vakil N. Cyclic vomiting syndrome in adults. Neurogastroenterology and Motility 2008;20:269-84.
Li BUK, LeFevre F, Chelimsky GG et al. NASPGHAN Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome. J Pediatr Gastroenterol Nutr 2008;47:379.
Tarbell S, Li BUK. Psychiatric symptoms in children and adolescents with cyclic vomiting syndrome and their parents. Headache 2008;48:259-66. Epub 2007 Dec 12.
Chelimsky TC, Chelimsky GG. Autonomic abnormalities in cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2007;44:326-30.
Boles RG, Adams K, Li BU. Maternal inheritance in cyclic vomiting syndrome. Am J Med Genet A. 2005;133;71-77.
Sudel B, Li BU. Treatment options for cyclic vomiting syndrome. Curr Treat Options Gastroenterol. 2005;8:387-395.
Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic vomiting syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005;3:20.
Li BUK, Misiewicz L. Cyclic vomiting syndrome: a brain-gut disorder. Gastroenterol Clin N Am. 2003;32:997-1019.
Boles RG, Adams K, Ito M, Li BU. Maternal inheritance in cyclic vomiting syndrome with neuromuscular disease. Am J Med Genet A. 2003;120:474-482.
INTERNET
Cyclic Vomiting Syndrome. Mayo Clinic Health Information. //www.mayoclinic.org/diseases-conditions/cyclic-vomiting-syndrome/symptoms-causes/syc-20352161. Accessed May 5, 2021.
Cyclic Vomiting Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. //www.niddk.nih.gov/health-information/digestive-diseases/cyclic-vomiting-syndrome. Accessed May 5, 2021.
Venkatesan T, Li B UK, Marcus S, Sundaram S, Pandey A. Cyclic Vomiting Syndrome. Medscape. Last Update: Oct 31, 2018. //emedicine.medscape.com/article/933135-overview. Accessed May 5, 2021.
URL of this page: //medlineplus.gov/genetics/condition/cyclic-vomiting-syndrome/
Cyclic vomiting syndrome is a disorder that causes recurrent episodes of nausea, vomiting, and tiredness (lethargy). This condition is diagnosed most often in young children, but it can affect people of any age. The episodes of nausea, vomiting, and lethargy last anywhere from an hour to 10 days. An affected person may vomit several times per hour, potentially leading to a dangerous loss of fluids (dehydration). Additional symptoms can include unusually pale skin (pallor), abdominal pain, diarrhea, headache, fever, and an increased sensitivity to light (photophobia) or to sound (phonophobia). In most affected people, the signs and symptoms of each attack are quite similar. These attacks can be debilitating, making it difficult for an affected person to go to work or school.
Episodes of nausea, vomiting, and lethargy can occur regularly or apparently at random, or can be triggered by a variety of factors. The most common triggers are emotional excitement and infections. Other triggers can include periods without eating (fasting), temperature extremes, lack of sleep, overexertion, allergies, ingesting certain foods or alcohol, and menstruation.
If the condition is not treated, episodes usually occur four to 12 times per year. Between attacks, vomiting is absent, and nausea is either absent or much reduced. However, many affected people experience other symptoms during and between episodes, including pain, lethargy, digestive disorders such as gastroesophageal reflux and irritable bowel syndrome, and fainting spells (syncope). People with cyclic vomiting syndrome are also more likely than people without the disorder to experience depression, anxiety, and panic disorder. It is unclear whether these health conditions are directly related to nausea and vomiting.
Cyclic vomiting syndrome is often considered to be a variant of migraines, which are severe headaches often associated with pain, nausea, vomiting, and extreme sensitivity to light and sound. Cyclic vomiting syndrome is likely the same as or closely related to a condition called abdominal migraine, which is characterized by attacks of stomach pain and cramping. Attacks of nausea, vomiting, or abdominal pain in childhood may be replaced by migraine headaches as an affected person gets older. Many people with cyclic vomiting syndrome or abdominal migraine have a family history of migraines.
Most people with cyclic vomiting syndrome have normal intelligence, although some affected people have developmental delay or intellectual disability. Autism spectrum disorder, which affects communication and social interaction, have also been associated with cyclic vomiting syndrome. Additionally, muscle weakness (myopathy) and seizures are possible. People with any of these additional features are said to have cyclic vomiting syndrome plus.
The exact prevalence of cyclic vomiting syndrome is unknown; estimates range from 4 to 2,000 per 100,000 children. The condition is diagnosed less frequently in adults, although recent studies suggest that the condition may begin in adulthood as commonly as it begins in childhood.
Although the causes of cyclic vomiting syndrome have yet to be determined, researchers have proposed several factors that may contribute to the disorder. These factors include changes in brain function, hormonal abnormalities, and gastrointestinal problems. Many researchers believe that cyclic vomiting syndrome is a migraine-like condition, which suggests that it is related to changes in signaling between nerve cells
Some cases of cyclic vomiting syndrome, particularly those that begin in childhood, may be related to changes in mitochondrial DNA. Mitochondria
Several changes in mitochondrial DNA have been associated with cyclic vomiting syndrome. Some of these changes alter single DNA building blocks (nucleotides), whereas others rearrange larger segments of mitochondrial DNA. These changes likely impair the ability of mitochondria to produce energy. Researchers speculate that the impaired mitochondria may cause certain cells of the autonomic nervous system to malfunction, which could affect the digestive system. However, it remains unclear how changes in mitochondrial function could cause episodes of nausea, vomiting, and lethargy; abdominal pain; or migraines in people with this condition.
In most cases of cyclic vomiting syndrome, affected people have no known history of the disorder in their family. However, many affected individuals have a family history of related conditions, such as migraines, irritable bowel syndrome, or depression, in their mothers and other maternal relatives. This family history suggests an inheritance pattern known as maternal inheritance or mitochondrial inheritance
Occasionally, people with cyclic vomiting syndrome have a family history of the disorder that does not follow maternal inheritance. In these cases, the inheritance pattern is unknown.
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