Cyclic vomiting syndrome

Area of Science:

• Pediatric Gastroenterology
• Neurology

Background:

• Cyclic vomiting syndrome (CVS) presents as recurrent vomiting episodes in children.
• Diagnosis of CVS is often delayed, with an average of 2.3 years between symptom onset and diagnosis.
• The prevalence of CVS ranges from 0.3% to 2%.

Purpose of the Study:

• To investigate the pathophysiology, prognosis, and natural history of CVS.
• To review current therapeutic strategies for CVS management.
• To highlight the recommendations from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) 2025 guidelines.

Main Methods:

• Review of existing literature and clinical data on CVS.
• Analysis of diagnostic delays and symptom onset in pediatric CVS cases.
• Compilation of NASPGHAN 2025 guideline recommendations for CVS treatment.

Main Results:

• The mean age of symptom onset was 5.7 years, and diagnosis was 8.0 years in children with CVS.
• No randomized control studies on abortive therapy for CVS have been conducted.
• NASPGHAN 2025 guidelines recommend specific acute and preventive medications, while cautioning against certain antiseizure drugs.

Conclusions:

• CVS diagnosis in children is challenging, necessitating further research into its underlying mechanisms and long-term outcomes.
• Current treatment approaches include a range of medications for acute episodes and prevention, guided by established pediatric guidelines.
• Antiseizure medications are reserved for severe, refractory cases unresponsive to other therapies.