Is it cvs or abdominal migraines?

[elgnirk]

Hi, my son is 5yrs. old, and for the past 3 1/2 yrs he has these episodes that cyle every 3 months to the day.  They begin at 4am each time.  He will wake up nauseated and start vomiting every 10-15 minutes for 8 hrs straight.  As soon as the vomiting stops he gets extremely dizzy, so much that he can't even move.  He is in bed for the first two days, then he tries to get up and play(because the constant dizziness is gone).  He always feels fine, so tries to play like normal, then all of a sudden it hits him and he curls up into a ball on the floor holding his head complaining of being dizzy(never of his head hurting). I should say that I noticed two episodes of high fever (104.8)that wouldn't come down for at least 6-8 hrs prior to any of this starting.  Each episode lasts for ten days, with the worst of it being over around the 5th day.  In August 2001 the episodes stared to change.  The vomiting time was shortened to 4 hrs and the dizziness wasn't so constant, but still lasting 10 days, and now  the episodes have been every 2 months. He also has a history of chronic ear infections for the past 2 yrs (one every month). He had Plagiocephaly from birth and wore a helmet to reshape his head (from 7 months to 12 months).  We have seen ENT, Neurologists,and even Geneticist.  Today infact we are going for EEG, and tomorrow a CT of head.  No doctor has ever wanted to put tubes in the ears.  Now they are talking about CVS vs. abdominal migraine?  They are suggesting putting him on Propranolol.  I don't think he fits either catagory very well, or does he?

[alisultaneh]

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[elgnirk]

Thank you very much.  It is very reassuring to get another opinion on my son's case.

[CCF-Neuro-M.D.-JT]

I'm not quite sure if you meant this with the abbreviation "CVS", but your son's symptoms do sound like they could be a special type of migraine called cyclic vomiting. It occurs more commonly in children than adults and the patient is completely healthy (and developing normally)inbetween the episodes of vomiting. Headache is usually NOT experienced by the patient during the episode. Many pediatric neuro docs feel that meds usually used in migraine prevention (such as the propanolol) can decrease the number and frequency of the attacks. Of course, it's important to make sure nothing else is causing the vomiting such as primary gastrointestinal problems such as obstruction or problems of metabolic origin (electrolyte and processing abnormalities). It's usually not a serious condition, and can be treated effectively with hydration and anti-nausea meds.

Having said that, your son may have other problems separate from this like the chronic ear infections which should be handled by the ENT docs. It is also possible that the vomiting may be part of a genetic syndrome as he had plagiocephaly at birth. The CT and EEG are a good start. BUt if everything comes back normal including the GI and metabolic workup, you could be dealing with cyclic vomiting. GOod luck.