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A Study on the Disease Course and Prognosis of Cyclic Vomiting Syndrome

Journal of the Korean Pediatric Society 2001;44(10):1141-1156.
Published online October 15, 2001.
A Study on the Disease Course and Prognosis of Cyclic Vomiting Syndrome
Hye Ran Yang, Jae Sung Ko, Jeong Kee Seo
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
주기성 구토증의 자연경과 및 예후에 대한 고찰
양혜란, 고재성, 서정기
서울대학교 의과대학 소아과학교실
Correspondence: 
Jeong Kee Seo, Email: jkseo@plaza.snu.ac.kr
Abstract
Purpose
: To describe clinical features of cyclic vomiting syndrome(CVS), managements during episodes, prophylactic drugs as long term therapy and to investigate the disease course and prognostic factors of CVS.
Methods
: Thirty two children who fulfilled the diagnostic criteria of CVS and who presented to Seoul National University Children's Hospital from March 1989 to December 2000, were included. Data were obtained from chart review and telephone interview.
Results
: All had recurrent, self-limited episodes and were free of symptoms between episodes. During the acute phase of episodes, lorazepam and ondansetron were effective in some patients. Various prophylactic drugs were tried and some patients recovered after the use of clobazam, clonazepam, erythromycin and imipramine. Among 32 patients, 18 had recovered from CVS. The age at recovery was 9.4?.0 years. It took 3.4?.2 years from the onset to the recovery. The age at onset was later in the recovery group than in the non-recovery group(6.1?.2 vs 1.7?.8 years; P=0.015) and the duration of episodes was longer in the recovery group(5.2?.6 vs 2.3?.2 days; P=0.003).
Conclusion
: Many patients recovered from CVS spontaneously. The prognosis in patients with later onset of the disease and the longer duration of episodes seemed to be better. Prophylactic drugs such as clobazam, clonazepam, erythromycin and imipramine may be beneficial. A total approach including trials of prophylactic drugs, removal of the triggering factor and psychiatric support is needed in the management of CVS.
Key Words: Cyclic vomiting syndrome, Prophylactic drug, Prognosis


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