2021 Volume 53 Issue 1 Pages 54-57
Herein we report the case of a 7-year-old boy with cyclic vomiting syndrome (CVS) successfully treated with judicious management and medication of autism spectrum disorder (ASD) traits. Radical surgery for esophageal atresia (Gross C) was performed during the neonatal period. The patient’s mother and grandmother both had migraines. The cyclic vomiting began when he was 1 year and 4 months of age, and the episodes occurred 1-3 times monthly. Various drug treatments were tested, but were not effective in controlling the vomiting events. The patient was referred to our hospital at the age of 7 years and 4 months for consultation and treatment. We arrived at a diagnosis of ASD due to observable traits including avoidance of eye contact, obsessiveness, and difficulty in communication. Subsequently, we began individual support and medication for ASD traits to alleviate the CVS. The school has begun to support for his behaviors associated with ASD. Consequently, the psychological anxiety regarding school attendance was addressed, allowing the patient to return to school. When prophylactic drug treatment was changed to the combination of risperidone, amitriptin, and sodium valproate, the vomiting attacks discontinued. The patient is now aged 9 years and 3 months, and has experienced no recurrent vomiting episodes in the past 14 months. In conclusion, it is important to consider the possible coexistence of developmental disorders in patients with intractable CVS, and to provide the reasonable accommodation and treatment for optimal outcomes.
