Management of Resistant Cyclic Vomiting Syndrome With a New Empiric Treatment in the Prophylaxis Period: A Case Report and Review of Literature

Abstract

Introduction: Cyclic Vomiting Syndrome (CVS) is an idiopathic disorder, identified by recurrent stereotypic episodes of severe nausea and vomiting and intervals of normal health between episodes. There is no specific diagnostic test for CVS, and clinical features are relied on for diagnosis. Many medications have been used to treat CVS, such as antiemetic, anti-migraine, and sedative medications. Nevertheless, treatment is difficult in some resistant cases. Case Presentation: We report a child with frequent and intensive vomiting episodes after an asymptomatic 2-year period. The patient was unresponsive to many medications but was successfully treated with chlorpromazine and then controlled using olanzapine, followed by aripiprazole. We also performed a brief literature review related to this case report in international databases. Conclusions: Since CVS management has remained challenging to the clinician in the severe and resistant patients, the empiric treatment of CVS is recommended.

Keywords

• cyclic vomiting syndrome
• treatment
• olanzapine
• aripiprazole