Cyclic Vomiting Syndrome LT Greg Gorman. Features Diagnosed 3-6 times a year in tertiary hospitals. 20-30 times a year in Germany after WW2 Boys and girls.

Slides:

Advertisements

Similar presentations

بسم الله الرحمن الرحيم Headache and facial pain Dr.Hayder Kadhum H. FICM NEUR. /Fellow Ship-Luvan university KUFA COLLEGE OF MEDICINE.

Advertisements

Abdominal pain in children SGD Dr Saffiullah AP Paeds.

TYLA GREEN EBONY PATTERSON KNALILAH

Chapter 16 Depression. Two Major Categories of Mood Disorder Major depressive disorder (unipolar): Lengthy, uninterrupted periods of depressed mood. Manic.

Dr. Zhao TCM Help Migraine Remedy: Acupuncture and Herbs Time: 1-2 weeks the Migraine is away. Cost: $380CAD Success Rate: >85%. Offer Herbs for prevention.

Peptic Ulcer Disease Biol E /11/06. From: Current Diagnosis & Treatment in Gastroenterology - 2nd Ed. (2003)

HISTORY TAKING Dr.Moeen-uz-zafar

+ Cyclic Vomiting Syndrome ((April Dougherty)). + No known causes Mostly found in children Dehydration Electrolyte imbalance (loss of important salts.

Migraines Mark Green, MD Clinical Professor Department of Neurology Columbia University New York, NY.

بسم الله الرحمن الرحيم كل عام وانتم بخير Headache and facial pain Dr.Hayder Kadhum H. FICM NEUR. /Fellow Ship-Luvan university KUFA COLLEGE OF MEDICINE.

Ulcerative Colitis.

2008. Diagnostic criteria  At least 10 episodes fulfilling following criteria  Headache lasting 30 mins to 7 days  Has 2 at least 2 of the following.

Sue Lipscombe Brighton GP Sue Lipscombe Brighton GP Children’s Headaches 0-18?

Headaches Continued. Examination 3 minute neurological test.

Paediatric headaches Mark Weatherall London Headache Centre 2010.

Chronic Abdominal Pain

History and Physical Health Science.

Salt: How much, how often, and why? Julie Matel, MS, RD, CDE CF Center Dietitian.

Relationship of Stress to Migraine Headaches. Type of headache Intense throbbing pain of the head, temples or behind one eye or ear Can also cause nausea.

跳转到第一页 Headache Zheng Dongming. 跳转到第一页 n The most common symptom in clinic n the causes are myriad. 1.intracranial disease 2.extracranial disease 3.functional.

Irritable Bowel Syndrome Biol E-163 TA session 12/18/06.

Presentation by: Leshawnda Willingham & Gloria Melchor Presented for Dr. Ryan Bellacov, chiropractor in West Linn, OR.

Medical conditions awareness session: Migraine in children and young people. Information for supervising adults.

Migraine Headaches By Robby Hammonds. Causes of Migraines Some of the main causes of these headaches are food, stress, bright lights, sounds, changes.

Headaches By: Gabie Gomez. Why does my head hurt ????? Headaches are a neurological complaint that can be insignificant or prodromal. The exact mechanism.

Diagnosis and management of primary headache

39-year-old woman with ‘monthly’ headaches Presented by: Anne MacGregor Barts Sexual Health Centre, St. Bartholomew’s Hospital, London, UK CLINICAL CASE.

Headache Dr. Mansour Al Moallem.

Rational brain imaging in primary care

Medical conditions awareness session: Migraine in children and young people.

Norwalk Virus Agenda Norwalk History How Does Norwalk Virus Work How is the Virus transmitted Signs and Symptoms Norwalk Statistics Therapy / Treatment.

Enzyme Case Studies: 1 A 67 year old male two days after sustaining multiple injuries in a motor vehicle accident complains of chest pain. There is no.

School of Clinical Medicine School of Clinical Medicine UNIVERSITY OF CAMBRIDGE Headache Jane Smith, a 23 year old woman, presents to her GP complaining.

Bipolar Spectrum Diagnosing and Differentiating From Depression Christopher D. Cobbs, M.D. 13 October 2010.

Sleep Disorders

History Taking. Why do we take history from the patient?

EPI Case Study 2: Complex Diagnostic Challenge of a Patient Presenting With Anxiety Attacks This is not an actual case study. It has been adapted.

Paradoxical Vocal Fold Movement (PVFM) Also know as... Vocal Cord Dysfunction Vocal Cord Malfunction Laryngeal Dyskinesia Inspiratory Adduction Paroxysmal.

NYU Medical Grand Rounds Clinical Vignette Ramin S Hastings, MD PGY-3 September 8, 2010 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

NYU Medicine Grand Rounds Clinical Vignette Himali Weerahandi, PGY3 March 6, 2012 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

BIPOLAR DISORDER DR GIAN LIPPI CONSULTANT PSYCHIATRIST

History Taking Dr. Muhammad Wasif Haq. How Do We Diagnose A Patient? History Examination Investigations Accurate history is almost half the diagnosis.

Shanika Uduwna PGY 2. 1.Age of onset 2.Semiology 3.EEG 4.outcome.

Differential Diagnosis. Salient Features Often observed to be absent minded Brief episodes of blank staring and inattention Eye blinking Reflex scratching.

ELS PEDS ! MCH protocols and peds exam for adult trainees.

Clinical Presentation of DHF. Dengue should be considered in the differential diagnosis of febrile patients with a history of travel to the tropics in.

LAFAYETTE HOME HOSPITAL: EPILEPSY; 2004 LAFAYETTE HOME HOSPITAL: EPILEPSY; 2004.

History taking and physical examination. KEY ELEMENTS Introduce yourself,(name and position) Rapport with patient, Beginning start with open ended questions,

CLINICAL FEATURES OF MIGRAINE. New words Migraine 偏头痛 Migraine 偏头痛 Aura 先兆 Aura 先兆 Teichopsia 闪光暗点 Teichopsia 闪光暗点 Hemianopic field defects 视野缺损 Hemianopic.

Colon Mass SGD. Case A 45‐year old female comes to the hospital with moderately severe colicky abdominal pain, abdominal distention, and nausea of two.

Habit disorders Dr. Ibrahim Khasraw Lecturer in Pediatrics School of Medicine Sulaimani University of.

Module Nine EATING DISORDERS Lesson 1: Anorexia Nervosa (2 training hours) Lesson 2: Bulimia Nervosa (1 training hour) TOTAL TIME: 3 TRAINING HOURS OF.

MEDICAL HISTORY CHECKLIST Samuel Aguazim ( MD). 1. Identification Information: Date the history was taken, Name of patient, Medical record number( If.

BRAIN GLIOMAS By:Tiphini Carroll. What causes Gliomas? The exact causes of gliomas are not known. Hereditary genetic disorders such as neurofibromatoses.

CLINICAL TIPS AND PEARLS. Clinical Tips and Pearls The more diagnoses made, the more medications tried, the more likely it is MOH. – When in doubt for.

Major Depressive Disorder Jannette Gonzalez Psychology Period 5.

Headache in General Practice 21 st October Headache ( To differentiate secondary from primary.

Puberty & Sex Education SECONDARY I HEALTH. What is puberty?

Heatwave advice. Looking after yourself in hot weather…..

Migraine Headache Relief Migraine is a common cause of suffering in most people, resulting in lost work days. There is no need to live with the pain of.

Date of download: 6/27/2016 Copyright © 2016 McGraw-Hill Education. All rights reserved. Panayiotopoulos Syndrome. A 5-year-old girl with nocturnal GTCS.

Case: 6yo girl with staring spells. Case 6 year old girl with history of ADHD, otherwise healthy, presenting for evaluation of staring spells. She was.

Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College

Facts About Headache. A headache is defined as "a pain or ache in the head...It accompanies many diseases and conditions, including emotional distress."

Question 4 – Redback spider

Irritable Bowel Syndrome (IBS)

IRRITABLE BOWEL SYNDROME

Clinical tips and pearls

DR. WALEED HADDAD ASS. PROF CONSULTANT ORTHOPAEDICS

Colorectal and General Surgical Topics Relevant to GPs GP update meeting Addington Practice Tuesday 26th March 2014 Mr Steve Warren.

Presentation transcript:

Cyclic Vomiting Syndrome LT Greg Gorman

Features Diagnosed 3-6 times a year in tertiary hospitals times a year in Germany after WW2 Boys and girls equally

Age of Onset

Episodes Episodes are similar 85% have uniform length episodes 1-70 episodes per year (avg. 12) 50% have regular cycle

Course in 5 y/o girl In hours; green boxes are episodes

Course in 12 y/o girl /2 11 wks14 wks 12 wks 10.6 wks In hours; green boxes are episodes 12 th birthday 1 st day of school Parents out of town Parents went to Dineyland without her

Course in 8 y/o girl In hours; green boxes are episodes

Course in 14 y/o boy In hours; green boxes are episodes

Duration of Episodes Fleisher, 1993

Timing of Episodes Charateristic timing in 76 % Usually upon awakening or middle of night Fleisher JPGN ‘93

Associated Symptoms Epigastric pain Nausea Saliva holding Loose stools (30 %) Headache (27 %) Fever (23 %) Occasional hypertension, tachycardia

Associated Symptoms Willingness to drink water “I drink the water because sometimes vomiting helps to relieve the nausea and, as far as I know I’m going to vomit anyway, it is far less unpleasant to bring up a dilute solution than to vomit concentrated hydrochloric acid…”

Associated Symptoms Triggers (75 %) Parental conflict (most common) Non-noxious excitement (birthdays etc) URIs Others: Menstruation, hot weather, exhaustion, motion sickness, specific foods, asthma attacks

Family History IBS (67 %) (2-6x normal prevalence) Migraine (11%) Motion Sickness (46%) Type A Personality (76%) Epilepsy (6%) (10x normal prevalence)

Course Over half symptom free 1 yr later Others last decades ? End at puberty

Pathogenesis Migraine equivalent Fits pattern and family history Eipileptic equivalent Case report of 5 seizure patients with CVS pattern

Differential Diagnosis Brain Stem Glioma Obstructive Uropathy Others

Management Anti-emetics Induction of sleep Resolution with consultation alone Psychosocial support