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[Cyclic vomiting syndrome in children].

G Ben-Amitay1, Y Nevo, D Lieberman

  • 1Ness Ziona Mental Health Center, Institute for Child Development Tel Aviv-Sourasky Medical Center.

Harefuah
|July 27, 2000
PubMed
Summary

Cyclic vomiting syndrome in children can stem from various issues, often without a clear organic cause. This case highlights a link between cyclic vomiting, headaches, and generalized anxiety disorder in a child.

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Area of Science:

  • Pediatric Gastroenterology
  • Child Psychiatry
  • Neuroscience

Background:

  • Cyclic vomiting syndrome (CVS) presents a diagnostic challenge in children, with diverse potential underlying causes including gastrointestinal, renal, neurological, metabolic, and endocrine factors.
  • Often, no definitive organic etiology is identified for CVS in pediatric populations.
  • Previous studies suggest personality traits like perfectionism and aggressive behavior, along with psychological stressors such as anxiety and excitement, may precipitate vomiting episodes.

Observation:

  • This report details an 8-year-old female experiencing frequent episodes of cyclic vomiting.
  • Her vomiting episodes were consistently accompanied by symptoms such as occipital headaches, photophobia, and dizziness.
  • The patient exhibited personality traits consistent with those previously described in children with CVS.

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Findings:

  • A comprehensive psychiatric evaluation revealed that the child suffers from a generalized anxiety disorder.
  • The clinical presentation suggests a strong correlation between anxiety and the manifestation of cyclic vomiting and associated symptoms in this pediatric patient.
  • No underlying gastroenterological, renal, metabolic, or endocrine disorders were identified as the primary cause of the vomiting.

Implications:

  • This case underscores the importance of considering psychiatric comorbidities, particularly anxiety disorders, in the differential diagnosis of cyclic vomiting syndrome in children.
  • Recognizing the psychological component may lead to more effective, integrated treatment strategies combining medical and psychiatric interventions.
  • Further research is warranted to elucidate the neurobiological pathways linking anxiety and cyclic vomiting in pediatric populations.