1.3.1 Cyclical vomiting

Description:

Recurrent episodic attacks, usually stereotypical in the individual patient, of vomiting and intense nausea. Attacks are associated with pallor and lethargy. There is complete resolution of symptoms between attacks.

Diagnostic criteria:

A. At least 5 attacks fulfilling criteria B and C

B. Episodic attacks, stereotypical in the individual patient, of intense nausea and vomiting lasting from 1 hour to 5 days

C. Vomiting during attacks occurs at least 4 times/hour for at least 1 hour

D. Symptom-free between attacks

E. Not attributed to another disorder (see Note 1.)

Note:

1. In particular, history and physical examination do not show signs of gastrointestinal disease.

Comment:

Cyclical vomiting is a self-limiting episodic condition of childhood, with periods of complete normality between episodes. This disorder was not included as a childhood periodic syndrome in the first edition of The International Classification of Headache Disorders. The clinical features of this syndrome resemble those found in association with migraine headaches, and multiple threads of research over the last years have suggested that cyclical vomiting is a condition related to migraine.

© 2003 International Headache Society (quoted from International Headache Society, 2004)

References

International Headache Society. The International Classification of Headache Disorders, 2nd edition. Cephalalgia 2004; 24 (suppl. 1): 1-160.

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