Short- and long-term outcomes of children with cyclic vomiting syndrome.

OBJECTIVE To determine the efficacy of prophylactic pharmacotherapy on the short- and long-term outcomes of children with cyclic vomiting syndrome (CVS). MATERIAL AND METHOD Medical records were reviewed in 32 children who were diagnosed with CVS between 2000 and 2013. Efficacy ofprophylactic medications was classified as good vs. no response after treatment for three to six months. Long-term outcome was evaluated inpatients who had been diagnosedfor > or =2 years and classiied as 1) excellent: no episode, 2) good: one to two episodes, and 3) poor: three episodes or more during the past year. RESULTS At three to six months after treatment, good response to amitriptyline was significantly higher than propranolol (73% vs. 36%, p = 0.04). Of the 24 CVS patients whohad been diagnosed > or =2 years, data was available in 19 patients (mean age, 11.3 +/- 4.9; and mean duration from diagnosis to follow-up, 6.3+3.3 years). Excellent outcome was achieved in seven, good in seven, and poor in five children. Overall, the favorable long-term outcome (good and excellent) was 74%. Most children (86%) who hadfavorable long-term outcome had good response to the prophylactic medications in the early period of treatment. CONCLUSION Amitriptyline may be more effective than propranololforprophylaxis of CVS. However, a randomized controlled trial is required to confirm this result. Children with CVS have a relatively favorable long-term outcome, particularly those who initially responded well to the prophylactic medications.