Is cyclic vomiting syndrome related to migraine?

Objective: To examine the overlap between cyclic vomiting syndrome (CVS) an d migraine by comparing 2 subsets of children with migraine-associated and non-migraine-associated CVS. Methods: We studied all children <18 years of age who met the consensus cri teria for CVS after presentation to our pediatric gastroenterology service from 1986 to 1998. The clinical patterns and responses to treatment were ob tained from a combination of chart reviews and structured interviews. Results: Among 214 children identified as having CVS, 82% were classified a s having migraine-associated CVS based on 1 of 2 criteria-either a family h istory of migraines or subsequent development of migraine headaches. Compar ed with the non-migraine CVS subgroup, the migraine subset had milder episo des (20.7 +/- 27.3 SD vs 39.5 +/- 66.5 emeses/episode, P = .006); more symp toms of abdominal pain (83% vs 66%), headache (41% vs 24%), social withdraw al (40% vs 22%), photophobia (36% vs 16%, all P < .05); more frequent trigg ering events (70% vs 49%, P = .013) including psychologic stress (39% vs 22 %), physical exhaustion (23% vs 3%), and motion sickness (10% vs 0%); and a higher positive response rate to anti-migraine therapy (79% vs 36%, P = .0 02). Conclusions: The majority of children with CVS were subclassified as having migraine-associated CVS. The migraine-associated subgroup had less severe vomiting, manifested symptoms typical of migraine headaches, and had higher response rates to anti-migraine therapy. These findings strengthen the rel ationship between migraine and CVS.