Çocukluk Çağı Siklik Kusma Sendromlu Hastaların Klinik ve Demografik Özellikleri: Tek Merkez Deneyimi

Amaç: Siklik kusma sendromu genellikle günler süren ve intravenöz sıvı tedavisi ihtiyacı olan ağır kusma atakları ile karakterizedir. Bu sendrom çocukların yaklaşık %2’sini etkiler. Biz merkezimizde tanı alan siklik kusmalı hastaların klinik ve demografik özelliklerini sunmayı amaçladık.Gereç ve Yöntemler: Çalışmamız, Ankara Üniversitesi Çocuk Nöroloji Bilim Dalına başvuran ve siklik kusma tanısı alan 24 hastanın geriye dönük taranması şeklinde yapıldı. Hastaların tanısında Roma III kriterleri kullanıldı. Hastaların cinsiyeti, yaşı, ailede migren öyküsü, atak süresi, atak sıklığı ve kullanılan tedavi yöntemi kaydedildi. Ayrıca tüm hastalara kraniyal MRG ve EEG yapıldı.Bulgular: Çalışmaya alınan hastaların 9’u (%37.5) kız, 15’i (%62.5) erkekti, ortalama yaşları 10.9±3.8 (aralık: 5-17 yaş)’dı. Hastaların ortalama takip süresi 39.4±21.2 aydı. Hastaların MRG’lerı normaldi. 7’sinin (%29.2) EEG’sinde yavaş dalga parokisizmi mevcuttu, 17’sinin (%70.2) EEG’si normaldi. Toplam 24 hastanın 11’inde ailede migren öyküsüvardı. 10 hasta flunarizin, 4 hasta valproik asit, 1 hasta topiramat, 3 hasta topiramat+valproik asit, 1 hasta valproik asit+flunarizin, 5 hastaya proflaksi verilmeden takip edildi.Sonuç: Siklik kusma sendromlu hastaların tanısında gastroenterolojik, nörolojik ve metabolik değerlendirme ile birlikte, ataklar arasında hastaların tamamen semptomsuz olması, tipik kusma paternin klinik belirtileri gerekmektedir. Erken tanı ve doğru yaklaşım hastaların yaşam kalitesini belirgin bir şekilde düzeltebilir.

Anahtar Kelimeler:

Çocukluk çağı, Proflaksi, Siklik kusma sendromu, Tanı

Clinical and Demographic Characteristics of Cyclic Vomiting Syndrome in Childhood: Single Center Experience

Objective: Cyclic vomiting syndrome is usually characterized by severe episodes that last for days and often require intravenous fluid therapy. This syndrome affects approximately 2% of children. We aimed to present the clinical and demographic characteristics of patients diagnosed with cyclic vomiting at our center.Material and Methods: Our study was designed as retrospective screening of 24 patients diagnosed with cyclic vomiting at Ankara University’s Pediatric Neurology Department. The Rome III criteria were used in the diagnosis of the patients. Gender, age, family history of migraine, attack duration, attack frequency, and the treatment of the patients were recorded. In addition, cranial MRI and EEG was performed for all patients.Results: A total of 24 patients were evaluated. The average age of onset of the symptoms was 6.1 ± 2.44 months, the mean age of diagnosis was 8.2 ± 2.62 months and the average follow-up period was 39.4 ± 21.15 months. The MRIs of the patients were normal. While there was slow wave paroxysm in the EEGs of 7 patients (29.2%), the EEG was normal in the remaining 17 patients (70.2%). Ten patients (41.7%) were administered flunarizine, 4 patients (16.7%) valproic acid, 3 patients topiramate+valproic acid, 1 patient valproic acid+ flunarizine, and 1 patient (4.2%) was given topiramate as prophylaxis. No drug was used for prophylaxis in 5 patients (20.8%).conclusion: Other than gastroenterologic, neurologic and metabolic evaluations, the diagnosis of CVS must be based on the detailed history of the clinical manifestations of the vomiting pattern with complete symptom-free intervals between the attacks. Early diagnosis and a proper approach can significantly improve the quality of life of these patients

Keywords:

Childhood, Prophylaxis, Cyclic vomiting syndrome, Diagnosis,

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