Similarities in cyclic vomiting syndrome across age groups

Area of Science:

• Gastroenterology
• Pediatric Gastroenterology
• Neurology

Background:

• Cyclic vomiting syndrome (CVS) is recognized in children but its pathogenesis and treatment are poorly understood.
• CVS is occasionally diagnosed in adults, but it is unclear if these cases represent a distinct disorder.

Purpose of the Study:

• To compare clinical characteristics of cyclic vomiting syndrome (CVS) in patients with childhood onset versus adult onset.
• To determine if CVS in older subjects represents a unique disorder compared to childhood-onset cases.

Main Methods:

• Retrospective review of clinical data from 39 patients diagnosed with CVS.
• Comparison of clinical features between patients with symptom onset before age 12 (n=18) and those with onset at age 12 or older (n=21).

Main Results:

• Prevalence of prodromal symptoms, triggers, alleviants, associated symptoms (abdominal pain, diarrhea), and family history of migraine were similar between childhood- and adult-onset groups.
• Diagnosis delay was longer in older-onset patients (7.9 years vs 3.1 years).
• Episode duration was significantly longer in older-onset patients (3.8 days vs 2.0 days) and progressively increased with age up to 20 years.

Conclusions:

• Cyclic vomiting syndrome (CVS) exhibits similar characteristics regardless of age at onset, suggesting a common pathogenesis.
• Episode duration in CVS increases with age until approximately 20 years.
• Increased awareness and suspicion are crucial for reducing diagnostic delays in CVS.