[On the subject of the cyclic vomiting syndrome].
The cyclic vomiting syndrome is defined by episodes of vomiting lasting from hours to days with free intervals between episodes. Various symptoms can be associated with vomiting: nausea, abdominal pain, photophobia, fever, pallor, dehydratation, excess salivation, social withdrawal. Some factors often precipitate the crisis: infection, psychological stresses, menstruation. Excluding a medical condition, especially a gastro-intestinal or a neurological disease is compulsory for the diagnostic of cyclic vomiting syndrome. The cyclic vomiting syndrome shares many common features with migraine including treatment. Due to negative paraclinical testing, a psychiatric disease is often suspected in these children. Pathophysiology of cyclic vomiting syndrome is unknown. As for migraine, mitochondrial and ionic channels abnormalities are thought to play a role. Overactivation of hypothalamic-pituitary-adrenal axis and autonomic dysfunction seem to be involved too. Three clinical vignets will illustrate these aspects.
Faucher
S
S
Service de psychopathologie de l'enfant et de l'adolescent, hôpital Robert-Debré, 48, boulevard Sérurier, 75935 cedex 19, Paris, France.
Le Heuzey
M-F
MF
Rouyer
V
V
Mouren-Simeoni
M-Ch
MC
D000293:Adolescent; D001342:Autonomic Nervous System Diseases / Q000150:complications; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications; D007239:Infections / Q000150:complications; D008297:Male; D008598:Menstruation; D008881:Migraine Disorders / Q000150:complications; D028361:Mitochondrial Diseases / Q000150:complications; D010507:Periodicity; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications; D013577:Syndrome; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology / Q000628:therapy