flunarizine and Vomiting

Cyclical vomiting syndrome (CVS), and abdominal migraine (AM) are relatively unusual periodic syndromes, generally believed to be migraine equivalents, and are characterized by recurrent and severe paroxysmal episodes of vomiting and/or abdominal pain lasting hours to days, separated by weeks to months of no symptoms. Flunarizine is a calcium channel-blocking agent that has been used successfully as a prophylactic agent in the prevention of both childhood and adult-onset migraine syndromes. The purpose of this study was to evaluate the efficacy of flunarizine as a prophylactic/preventive agent in the treatment of CVS and AM. Eight children with CVS and 10 children with AM were included in the study. The mean dose of flunarizine was 5 mg/day in children with CVS, and 7.5 mg/day in children with AM. Follow-up ranged from 6 to 24 months (mean 13 months). There was a 57% reduction in frequency and 44% reduction in duration of attacks of CVS, and a 61% reduction in frequency and 51% reduction in duration of attacks of AM. Sixty-four percent of patients with CVS and AM had history of episodic recurrent headaches with 60% reduction in frequency of attacks on treatment. Flunarizine showed to be equally efficacious than previously tried therapies in the prophylaxis of a small cohort of patients with CVS and AM.

Topics: Calcium Channel Blockers; Child; Child, Preschool; Female; Flunarizine; Humans; Male; Migraine Disorders; Periodicity; Retrospective Studies; Syndrome; Treatment Outcome; Vomiting

Topics: Adult; Brain Stem Neoplasms; Calcium Channel Blockers; Child; Diagnosis, Differential; Epilepsy; Female; Flunarizine; Gastrointestinal Diseases; Humans; Menstruation; Metabolic Diseases; Migraine without Aura; Recurrence; Syndrome; Vomiting

Vestibular symptoms frequently occur in patients with migraine headache. The common migraine is defined in neurology as a unilateral, pulsating headache, which may be associated with nausea and vomiting, and lasts one or several days. In the classic form patients have visual prodromal symptoms. Focal neurological signs in the migraine complique include, for example, oculomotor palsy and vestibular abnormalities. This so-called vestibular migraine is different from basilar migraine, which involves the irritation of the cervical sympathetic system, and can cause symptoms that resemble transient brainstem ischemia. In order to evaluate vestibular dysfunction electronystagmography (ENG) was used. Patients frequently had abnormal caloric test responses, especially with a directional preponderance, and most had a spontaneous nystagmus. In the migraine attack the patients are presumed to have hypersensitivity of the labyrinth with nausea and vomiting, while in the headache-free period the ENG was almost normal. At present, we have had a high success rate in treating patients with pyracetam. Diazepam was used to treat basilar migraine and flunarizine to prevent vestibular migraine.

Topics: Adolescent; Adult; Aged; Basilar Artery; Calcium Channel Blockers; Caloric Tests; Child; Diazepam; Ear, Inner; Electronystagmography; Female; Flunarizine; Hearing Loss, Sensorineural; Humans; Ischemic Attack, Transient; Male; Middle Aged; Migraine Disorders; Muscle Relaxants, Central; Nausea; Neuroprotective Agents; Nystagmus, Pathologic; Ophthalmoplegia; Piracetam; Sympathetic Nervous System; Vestibular Diseases; Vomiting