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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Clinical and epidemiological features of cyclic vomiting syndrome

Clinical and epidemiological features of cyclic vomiting syndrome
Feature Characterization
Female:male ratio 55:45
Mean age of onset 5.3 years in children, 35 years in adults
Morbidity 20 days of missed school per year; 50% of patients require intravenous hydration
Symptoms:
Vomiting 6 to 8 times/hour at peak, often with bile and blood
Autonomic Lethargy, pallor; sometimes with fever or copious salivation
Gastrointestinal Abdominal pain, retching, anorexia, nausea; sometimes diarrhea
Neurologic Migraine-like symptoms in approximately one-third of patients, including headache, photophobia, phonophobia, or vertigo  
Behavioral 
  • Use of hot-water showers or bathing to attenuate nausea (similar to cannabis hyperemesis syndrome, but also occurs in children and >50% of adult CVS patients without exposure to cannabis)
  • Rapid drinking of fluids before onset of vomiting due to bitterness of bile
Temporal pattern Most patients have a stereotypical pattern; most episodes occur at night or early morning
 

Children (or adults with pediatric-onset CVS):

  • Mean duration 2 days
  • Mean 12 cycles/year
  • Triggering events identified in 70% of patients; includes infection (40%), psychological stress (35%), dietary (25%)*, menstrual (10%), cannabis withdrawal
  • Interepisodic nausea rare (12%)

Adult-onset CVS:

  • Mean duration 6 days
  • Mean 4 cycles/year
  • Triggering events are similar to those in children but may be less common
  • Interepisodic nausea common (40 to 60%)
Association with migraines
  • Children – Approximately 30% of patients progress to migraine headaches by early adolescence, and 75% progress to migraines by 18 years
  • Adults – Approximately 50% have migraine headaches 
Family history of migraine Present in 40 to 80% of children and 25 to 70% of adults
CVS: cyclic vomiting syndrome.
* Commonly reported food triggers include chocolate, cheese, and monosodium glutamate. A causal association has not been established.
Adapted from: 
  1. Li BU, Balint JP. Cyclic vomiting syndrome: Evolution in understanding of a brain-gut disorder. Adv Pediatr 2000; 47:117.
  2. Li BU. Cyclic vomiting: New understanding of an old disorder. Contemp Pediatr 1996; 17:48.
  3. Abell TL, Adams KA, Boles RG, et al. Cyclic vomiting syndrome in adults. Neurogastroenterol Motil 2008; 20:269.
  4. Kumar N, Bashar Q, Reddy N, et al. Cyclic Vomiting Syndrome (CVS): is there a difference based on onset of symptoms--pediatric versus adult? BMC Gastroenterol 2012; 12:52.
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