Cyclic vomiting syndrome in children: Experience with 181 cases from southern Iran

Mahmood Haghighat, Seyed Mohammad Rafie, Seyed Mohsen Dehghani, Gholam Hossein Fallahi

AIM: To evaluate the clinical presentation, response to prophylactic therapy and outcome of children with cyclic vomiting syndrome (CVS) IN Shiraz, Iran.

Methods: During a period of 11 years March 1994 to March 2005), 181 consecutive children, treated and followed in our center. Patients were randomized to receive either amitriptyline or propranolol as prop actic treatments.

RESULTS: There were 88 boys and 93 grils with mean age of onset of symptoms of 4.9±3.3 years (range, neonatal period to14 years), the mean age at final diagnosis was 6.9 years (range, 1.5 to 14), and the mean duration between the onset of the first attack and the final diagnosis of CVS was 2±1.81 years (range, 1/6 to 8). The mean duration of each attack was 4.26 days (range, from few hours to 10 d) and the mean interval between the attacks was 1.8 mo (range, 1 wk to 12 mo). The time of onset of the attacks was midnight to early morning in about 70% of cases. Amitriptyline was effective in 46 out of 81 (56%) patients (p<0.01). propranolol appeared to have a superior action and was effective in. 74 out of 83 (92%) patients (p<0.001).

CONCLUSTION: There is a significant lag time between the onset of clinical symptoms and with typical clinical presentations of CVS, who are examinead by an examined by an experienced physician, invasive than amitripthline for prophylactic use in children with CVS.

Keywords: Cyclic vomiting syndrome; Children, propranolol; Amitriptyline