[Cyclic vomiting in children]

Two girls aged 13 and 10 suffered from recurrent episodes of severe vomiting. After excluding underlying pathological conditions the diagnosis of cyclic-vomiting syndrome was made. They were treated by intravenous fluid suppletion and drugs such as propranolol, pizotiphene, diclophenac, granisetron, lorazepam and pantoprazole. Eventually they recovered. Cyclic-vomiting syndrome is probably a common but often not recognised syndrome. It should be considered in all children with multiple episodes of vomiting. It is characterized by the sudden occurrence and spontaneous disappearance of symptoms followed by a completely symptom-free interval. The incidence has been estimated to be as high as 2% in some populations of school children. The syndrome is often not diagnosed if the episodes are mild and diagnosed late if the symptoms are severe. To avoid too many investigations the suggested diagnostic protocol can be followed. Prophylactic therapy with anti-migraine medication should be attempted, notably with propranolol, early in the course of the disease.