CYCLIC VOMITING SYNDROME AND MIGRAINE
A possible relationship between Cyclic Vomiting Syndrome (CVS) and migraine was first suggested in 1920. Several subsequent studies have reported migraine headaches among CVS patients, as well as among first and second degree relatives. However none of these studies had reference groups for the estimated prevalences. To evaluate the possibility of a genetic association between CVS and migraines more systematically, the present study was undertaken to compare family histories of patients with CVS to a control group.
In early 1995, the Cyclic Vomiting Syndrome Association of USA/Canada (CVSA) developed a questionnaire to be completed by all CVS patients who came into contact with the CVSA. All persons who had completed the questionnaire as of July 1997 (n=250) were asked to identify an individual of the same gender, race and age (+/- one year) who lived within one mile of their home to complete the same block of questions on demographics, patient history, family history and personality characteristics contained in the original questionnaire. The family history section of the questionnaire included specific questions on the prevalence of recurrent (non-migraine) and migraine headaches in first, second and third degree relatives.
As of March 1998, 112 control questionnaires have been returned (45%). Upon verifying that the control individual matched the patient on the specified characteristics, the corresponding case data (n=112) was added for the control analysis. Twenty one of the 112 patients reported migraine headaches (18.8%), compared with 7 of the 112 controls (6.3%), a significant difference (p<0.01). Moreover, the number of first degree relatives suffering from migraines was significantly higher among those with CVS (39.9% vs 26.98% among controls, p<0.05) as was the percent of second degree relatives reported as having a history of migraines (48.2% vs 25.0%, p<0.001).
This study confirms previous suggestions that migraine, usually a genetic disease, occurs more frequently in relatives of affected individuals with CVS than those without CVS.
Together with the frequent presence of headaches or typical migraine in patients with CVS, and progression to classical migraine, affirms the hypothesis that CVS is a migraine equivalent.
This is the abstract of a poster presented at the 2nd International Scientific Symposium held in Milwaukee, USA, April, 1998.
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