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Cyclic Vomting (Epidemiology (Link with Migraines, Comonly diagnosed 3-7yr…
Cyclic Vomting
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Clinical Findings
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Early Morning 3-4 am, waking
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Identifiable trigger in children such as birthday, holiday or school functions
Exam is negative, but appear more ill than gastritis
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Management
Well phase/Prophylactic
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Children >5 yr
Amitriptyline 1st choice 0.25mg-0.5mg/kg/bed time increase to 5-10mg Monitor ECG before starting and 10 days into peak dose
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Episodic/ Supportive
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Antimigraine- Triptan medications in children older than 12 - Sumatriptan nasal 20mg on onset of basilar migraine
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Education
Understand Triggers, plan of care with families
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