Positive outcome of administering palonosetron and haloperidol combination in cyclic vomiting syndrome: a case report.

Abstract

Background: Cyclic vomiting syndrome (CVS) is a rare disorder in which a patient suffers from recurrent episodes of nausea and vomiting. Onset usually occurs early in childhood, later it might progress into a chronic condition highly affecting on the quality of life. No solid treatment protocol is available to treat CVS. There are many cases in which no improvements are observed after years of trying different treatment regimens. Case Presentation: Here we report a 15-year-old female who was diagnosed as a patient of CVS at the age of 7. She was admitted to the medicine ward within 3 hours of onset in the last year. The patient possesses a history of a unique pattern of onset. She has been hit by the recurrence of the disorder almost once in 8-11 months, lasting for 10-14 days, manifesting as intense nausea, and vomiting once in every 20-40 minutes followed by irregular asymptomatic intervals. Various treatment regimens of unsatisfactory outcome were applied on this patient over the years. After analyzing her previous treatment protocols, we decided to try something new and aggressive, moving with palonosetron and haloperidol, a combination that was never applied on this patient. Conclusion: The outcome was ‘magical' according to the parents of the patient marked by declining of the symptom immediately and complete relief within the next 72 hours, the earliest ever after having onset for this particular patient's past history of encountering CVS.