A Case Series of Cyclic Vomiting Syndrome in Children at Pediatric Gastroenterology Clinic in Benghazi Medical Center

Abstract

Background: Cyclic vomiting syndrome (CVS) is a functional disorder characterized by repeated episodes of sudden onset of intense vomiting that is followed by symptom-free periods. The diagnosis is based on the fulfillment of Rome IV criteria. The Cyclic vomiting syndrome shares similar features to migraine headaches. It is under-recognized and often misdiagnosed with significant delays in therapy. Aims: To evaluate the clinical characteristic of pediatric patients diagnosed with cyclic vomiting syndrome in our institution and their response to treatment. Patients and Methods: A prospective case series of 13 pediatric patients with cyclic vomiting syndrome seen between period of November 2018 to November 2020 at pediatric gastroenterology outpatient’s clinic in Benghazi medical center. All relevant data including; age and sex, age of presentation, duration of symptoms, age at diagnosis, presence of aura or prodromal symptoms, patient or family history of headache, treatment and their response to treatment were collected. Results: The mean age for diagnosis was 112.2 ± 37.7 months. 46.2% of patients had recognizable prodromal symptoms. Patients with CVS had intense nausea and persistent vomiting that requiring hospitalization. In 44.4% of patients had stopped the episodes as a response to propranolol. Conclusion: Cyclic Vomiting Syndrome (CVS) is a functional, an under-recognized, and misdiagnosed episodic. The illness is characterized by stereotypical pattern of vomiting leading to frequent hospitalizations.