Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has long been recognized that some cases of recurrent abdominal pain in children are related to migraine, but the diagnostic criteria for abdominal migraine have not been defined. We have identified a group of children with recurrent abdominal pain who had a family history of migraine--in over half the cases in a first-degree relative--and who obtained marked relief from their symptoms from specific anti-migraine therapy. These children had a well-defined syndrome comprising episodes of midline abdominal pain of sufficient severity to interfere with normal activities and lasting for prolonged periods, frequently accompanied by pallor, headache, anorexia, nausea, and vomiting. It is proposed that these children have "abdominal migraine".
 ...
PMID:Abdominal migraine: a childhood syndrome defined. 380 89

Abdominal migraine and cyclic vomiting are both self-limiting episodic conditions of children, with periods of complete normality between episodes. The clinical features of both syndromes show considerable similarity, and resemble those found in association with migraine headaches. It is proposed that cyclic vomiting is a condition related to migraine.
 ...
PMID:The relationship between cyclic vomiting syndrome and abdominal migraine. 870 67

Neurologic studies of childhood migraine, including imaging techniques and electrophysiology, have identified a number of abnormalities, but none of high specificity. Therefore, a diagnostic marker for childhood migraine and its equivalents remains elusive. In this study a combined electrophysiologic approach is assessed, using measurements of visually provoked beta-activity, high-frequency photic following responses, and visually stimulated event-related potentials. Eighteen children younger than 10 years of age with abdominal migraine and/or cyclic vomiting syndrome were investigated with these techniques. They were compared with the responses from a number of control groups, including a group diagnosed as childhood migraine with or without aura. Individually, each investigation yielded high sensitivities but low specificities ( < 50%). However, when these techniques were used in combination the specificity for migraine rose to > 90%. There was no significant difference between abdominal migraineurs and those with migraine with or without aura in any of the parameters studied. This combined approach is potentially useful in the diagnosis of abdominal migraine and supports the view that abdominal migraine can be classed as a true childhood migraine equivalent.
 ...
PMID:Neurologic investigations of childhood abdominal migraine: a combined electrophysiologic approach to diagnosis. 870 68

Although it remains a mysterious disorder since its description over a century ago, cyclic vomiting syndrome appears to be more prevalent than previously thought. With the goal of improving detection of affected children, two quantitative historical criteria-peak intensity > or = 4 emeses/h) and a episode frequency < or = 9/ month-can differentiate those with an explosive, intermittent cyclic pattern from those with a low-grade, daily chronic pattern. Diagnoses that can cause a cyclic vomiting pattern includes abdominal migraine, chronic sinusitis, intracranial neoplasm, anomalies of and mucosal injury to the gastrointestinal tract, urologic abnormalities, and metabolic and endocrine disorders. Because many organic disorders can mimic cyclic vomiting syndrome, a systematic diagnostic evaluation of potential underlying disorders is recommended. The following terminology is proposed: a cyclic pattern is differentiated from a chronic pattern of vomiting on the basis of a higher peak intensity of emesis and lower frequency of episodes; and of those with a cyclic vomiting pattern, an idiopathic subgroup who is not found to have an underlying disorder on diagnostic testing can be labeled as having cyclic vomiting syndrome.
 ...
PMID:Cyclic vomiting: the pattern and syndrome paradigm. 870 72

Cyclic vomiting is a rare syndrome that over the years has variously been ascribed to psychogenic causes, sensory seizures, abdominal migraine, and more recently, to mechanical or electrical disturbances in gastric physiology. We describe the case of a 65-year-old white diabetic female with a 10-yr history of recurrent episodes of nausea and vomiting, occurring every 10-12 days and lasting approximately 1-3 days at a time. These episodes were accompanied by edema, mild temperature elevations, and remarkable elevations in blood pressure. In between these episodes, the patient remained asymptomatic. Initial screening tests were also negative except for moderate gastroparesis. However, antral motility was found to be normal, as was an electrogastrogram. Detailed neurological and psychiatric evaluations were negative. Trials of erythromycin, metoclopramide, naloxone, ondansetron, and amitryptiline were unsuccessful. Serial endocrinological testing revealed that an episode of vomiting was always preceded by an abnormal elevation in at least one of the following: serum adrenocorticotropic hormone, serum cortisol, or urinary cortisol. In the midst of an episode, all three values were exceedingly high (e.g., > 10-fold increases in 24-hr urinary cortisol levels). Fluctuations of a milder degree, though still abnormally high, were also noted in between cycles at times when the patient was completely asymptomatic. High-dose dexamethasone suppressed these hormonal surges completely but not the clinical symptoms, which continued undisturbed. The patient was finally given a trial of intramuscular ketorolac during one of her episodes, which produced prompt and sustained relief. During the next few weeks, she was given this drug each time her symptoms commenced, and each time it appeared that her cycle had been aborted. She has since been able to terminate her episodes promptly and completely by self-administration of ketorolac. We speculate that her syndrome is caused by a poorly characterized disorder of endogenous prostaglandin release, resulting not only in derangements in the hypothalamic pituitary system but also in nausea and vomiting.
 ...
PMID:Cyclic vomiting: association with multiple homeostatic abnormalities and response to ketorolac. 885 55

This is the first attempt at defining criteria for functional gastrointestinal disorders (FGIDs) in infancy, childhood, and adolescence. The decision-making process was as for adults and consisted of arriving at consensus, based on clinical experience. This paper is intended to be a quick reference. The classification system selected differs from the one used in the adult population in that it is organized according to main complaints instead of being organ-targeted. Because the child is still developing, some disorders such as toddler's diarrhea (or functional diarrhea) are linked to certain physiologic stages; others may result from behavioral responses to sphincter function acquisition such as fecal retention; others will only be recognizable after the child is cognitively mature enough to report the symptoms (e.g., dyspepsia). Infant regurgitation, rumination, and cyclic vomiting constitute the vomiting disorders. Abdominal pain disorders are classified as: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain, abdominal migraine, and aerophagia. Disorders of defecation include: infant dyschezia, functional constipation, functional fecal retention, and functional non-retentive fecal soiling. Some disorders, such as IBS and dyspepsia and functional abdominal pain, are exact replications of the adult criteria because there are enough data to confirm that they represent specific and similar disorders in pediatrics. Other disorders not included in the pediatric classification, such as functional biliary disorders, do occur in children; however, existing data are insufficient to warrant including them at the present time. For these disorders, it is suggested that, for the time being, clinicians refer to the criteria established for the adult population.
 ...
PMID:Childhood functional gastrointestinal disorders. 1045 47

Cyclical vomiting is an intermittent episodic disorder found most commonly in children. It bears considerable similarities to abdominal migraine and to migraine headaches. It has been proposed that cyclical vomiting is a form of or juvenile equivalent of migraine and that there is a spectrum of disease encompassing cyclical vomiting, abdominal migraine, and migraine headaches. There are considerable overlaps among the syndromes that support this concept. It seems, however, unlikely that all cases of cyclical vomiting are migranous in origin.
 ...
PMID:Is cyclical vomiting an abdominal form of migraine in children? 1049 35

Cyclic vomiting syndrome (CVS) remains a mysterious disorder despite our increasing knowledge since its classic description by Gee in 1882. Its hallmark feature of recurrent, explosive bouts of vomiting punctuating periods of normal health causes substantial medical morbidity (50% of patients require intravenous therapy), as well as significant time lost from school (20 school absences per year) and work. Limited epidemiologic data indicate that CVS may occur more commonly than previously thought, affecting as many as 1.9% of school-aged children. Besides the relentless vomiting, the child usually has pallor (87%), lethargy (91%), anorexia (74%), nausea (72%), and abdominal pain (80%). There is evidence of clinical and physiologic overlap among CVS, abdominal migraine, and migraine headaches. We propose revised criteria for abdominal migraine that include pain as the predominant and consistent symptom, lack of abnormal screening tests, and in retrospect, either subsequent development of migraines or positive response to antimigraine medication. Besides migraines, other etiologic possibilities include mitochondrial DNA mutations, ion channelopathies, excessive hypothalamic-pituitary-adrenal axis activation, and heightened autonomic reactivity. The differential diagnosis includes idiopathic CVS (88%); gastrointestinal disorders (7%), including serious surgical disorders (e.g., malrotation); and extraintestinal disorders (5%), including serious surgical (brain stem neoplasm) and metabolic disorders (e.g., fatty acid oxidation disorder). Within the idiopathic group, there may be migraine, Sato's neuroendocrine, mitochondrial, and other subgroups. Treatment includes avoidance of triggers, prophylactic medication, supportive care, abortive medication, and family support. In the future, investigation into mitochondrial DNA mutations, ion channel defects, corticotropin-releasing factor, and serotonin and tachykinin receptor physiology and pharmacology may help discover the etiology and pathogenesis of this disorder.
 ...
PMID:Cyclic vomiting syndrome: evolution in our understanding of a brain-gut disorder. 1095 42

Migraine equivalents of infancy, childhood, and adolescence are recognized periodic, paroxysmal syndromes without associated headache that are thought to be migrainous in etiology. Five such equivalents are presently recognized. Their clinical features and relative frequency in ambulatory pediatric neurology practice have not been well documented. Utilizing a comprehensive, standardized computer database, the occurrence of these migraine equivalents in a single pediatric neurology practice together with their observed clinical features were documented over an 8-year period. Of a total of 5,848 patients in the database, of whom 1,106 were migraineurs, 108 patients (1.8% of total, 9.8% of migraineurs) were identified to have migraine equivalents. The following distribution among migraine equivalents was observed: benign paroxysmal torticollis 11 (10.2% of patients with migraine equivalents), benign paroxysmal vertigo 41 (38%), abdominal migraine/cyclical vomiting 20 (18.5%), acephalgic migraine 31 (28.7%), and acute confusional migraine 5 (4.6%). In each type, with the exception of benign paroxysmal torticollis and acute confusional migraine, females clearly predominated, and in all types a strong positive family history of migraine was elicited (68%-100%). There was variation in the age of onset of a particular equivalent with considerable overlap observed. Coexisting more typical migraines were observed in from 10% (benign paroxysmal torticollis) to 70% (abdominal migraines/cyclical vomiting) of the cases. In conclusion, pediatric migraine equivalents occur with relative frequency in ambulatory practice, possessing discrete clinical features that have a clear relationship to more typical migrainous phenomena.
 ...
PMID:Pediatric migraine equivalents: occurrence and clinical features in practice. 1250 14

Vomiting and abdominal pain are symptoms that may arise from a number of different causes. Cyclical vomiting and abdominal migraine are terms that have been applied to a presentation characterized by its episodic pattern and intervals of complete health. The 2 share many clinical features, but it is important to distinguish them as they have different responses to therapies such as prophylactic antimigraine medications. Both are noted for the absence of pathognomonic clinical features but also for the large number of other conditions to be considered in their differential diagnoses. Definitive diagnosis is frequently delayed. It is important to carefully evaluate these patients as well-being between vomiting episodes does not guarantee the absence of organic disease. While there is a role for a basic set of diagnostic tests, there is evidence to suggest that a trial of empiric therapy with upper gastrointestinal and small-bowel radiological studies is cost-effective.
 ...
PMID:Abdominal migraine and cyclical vomiting. 1465 64


1 2 3 4 Next >>