Anti-Migraine Approach to Treat Cyclic Vomiting Syndrome:Response to Anti-Migraine Therapy in Adult Patients

IntroductionCyclic vomiting syndrome and abdominal migraine share overlapping clinical features with migraine but lack the characteristic feature of headache.These characteristic clinical features of these conditions are recurrent episodes of nausea and vomiting associated with abdominal pain.These symptoms last for a few hours and may persist for a few days.Typically, there are symptom free periods and these patients remain well and symptom free between attacks.These conditions are usually present in childhood, however, it now recognized that both of these cyclic syndromes 1 can present for the first time in adulthood.Vomiting is a common gastrointestinal disorder in adults and patients suffering from this condition are sometimes misdiagnosed and undergo several invasive and un-necessary investigations and 2 consequently mismanaged as well.The emesis is coordinated by the vomiting center in the brain stem.This complex center located in the floor of the fourth ventricle in the medulla, has four different sources of afferent inputs.These sensory inputs include afferent vagal fibers from the gastrointestinal tract, sensory fibers from the vestibular system, inputs form higher central nervous system including the amygdala and chemoreceptor trigger zone.These diverse sensory