What are the signs and symptoms of migraine-associated cyclic vomiting syndrome?

Updated: Aug 15, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Amy Kao, MD  more...
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This syndrome is characterized by recurrent periods of intense vomiting, at least 4 times per hour, separated by symptom-free intervals, with attacks occurring at least 1 week apart. Many patients with cyclic vomiting have regular or cyclic patterns of illness. Symptoms usually have a rapid onset at night or in the early morning and last at least 1 hour and up to 10 days (usually 6-48 hours). Associated symptoms include the following:

  • Abdominal pain - 80%

  • Nausea - 72%

  • Retching - 76%

  • Anorexia - 74%

  • Pallor - 87%

  • Lethargy - 91%

  • Photophobia - 32%

  • Phonophobia - 28%

  • Headache - 40%

Headache often does not appear until the child is older. Migraine-associated cyclic vomiting syndrome usually begins when the patient is a toddler and resolves in adolescence or early adulthood; it rarely begins in adulthood. More females than males are affected by cyclic vomiting.

Infections, psychological stress, physical stress, and dietary triggers are often clearly identified in the patient's history. Examples of triggers include cheese, chocolate, monosodium glutamate (MSG), emotional stress, excitement, or infections. Usually, the parents or siblings have a family history of migraine.

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