Efficacy of nebivolol and amitriptyline in the prophylaxis of cyclic vomiting syndrome: a case report.
BACKGROUND
Cyclic vomiting syndrome (CVS) is an episodic disorder with recurrent attacks of nausea and vomiting. The exact cause of the disorder is still unclear. It was first described in children but may affect patients of any age. The syndrome is frequently misdiagnosed, and patients receive redundant investigations and treatments. Patients are referred finally to a neurologist because of the differential diagnosis of abdominal migraine or abdominal epilepsy.


METHODS
We present a 18-year-old girl with episodic nausea and vomiting attacks who was diagnosed as CVS. The attacks regressed with combination treatment with amitriptyline and nebivolol.


CONCLUSIONS
CVS has no specific diagnostic test and the diagnosis is based on history, clinical presentation and exclusion of other possible causes with similar presentation. The syndrome has a strong association with migraine; treatment options may also overlap. Treatment is still based on case series and reports. Here, we aim to present the clinical features as well as treatment response of a patient with CVS.
Erturk
Ozdem
O
Department of Neurology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. ozdemerturk@yahoo.com
Uluduz
Derya
D
Karaali-Savrun
Feray
F
D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use*; D000639:Amitriptyline / Q000627:therapeutic use*; D001578:Benzopyrans / Q000627:therapeutic use*; D002648:Child; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000068577:Nebivolol; D010507:Periodicity; D055502:Secondary Prevention; D013577:Syndrome; D016896:Treatment Outcome; D014839:Vomiting / Q000517:prevention & control*
D018759:Adrenergic Uptake Inhibitors; D058671:Adrenergic beta-1 Receptor Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D000639:Amitriptyline