Transcutaneous vagus nerve stimulation as a potential novel treatment for cyclic vomiting syndrome: a first case report

Excerpt

Cyclic vomiting syndrome (CVS) is a rare disorder characterized by recurrent episodes of intense nausea and vomiting that can last for a few hours up to several days [1]. This disorder is more common in children, with a mean age of onset from 3.5 to 7 years [2]. More recently, an adult form of the disease has also been identified, and associated with significant impairment of social and occupational functionality [3]. Evidence has emerged on the link between CVS and autonomic dysfunction, with orthostatic intolerance, postural orthostatic tachycardia and abnormal skin sympathetic nervous activity observed in the majority of patients with CVS [4‐6]. CVS has also often been described as an abdominal variant of migraine [7] since these two disorders share some clinical features (e.g., nausea, photophobia), as well as periodicity and types of triggers (e.g., acute stress and sleep deprivation) [7]. Several patients with CVS report comorbidity and/or family history of migraine [1, 2]. Current knowledge on the pathophysiological mechanisms of CVS is scanty, leading to serious difficulties in identifying an effective treatment. Antiemetic drugs have been often proposed as treatments [1], although these are associated with multiple side effects and rarely accompanied by a complete remission of the episodes. …