Abstract
Abdominal pain & vomiting are common complaints in adolescents. This is the third case who responded to treatment altering CNS neurotransmitters. Hyperemesis with wt. loss of 25 lbs. occurred in the first month of pregnancy. Recurrent vomiting between 1 & 9 months was diagnosed as plyorospasm & was not relieved by “drops”. At 8 years vomiting started again. During 40 hospitalizations, all tests were normal. Diagnosis was psychogenic vomiting which was unresponsive to phenobarbital, phentoin or chlorpromazine. During an attack, she had vomiting, mild abdominal pain, personality change, hypertension, fever, tachycardia, WBC 10-15,000 with high hGH and abnormal EEG, all of which were normal in symptom free periods. From 13-18 years, she had 25 admissions to UTMB including 1 year on a psychiatric unit. Treatment with chlorpromazine, trifluoperazine, phenobarbital, belladona, cyproheptadine or loxipane failed. Symptoms, lab data & response to previous therapy suggested a deficiency of CNS catechols or dopamine. Amytriptaline 150 mg/d was started to increase the concentration of these neurotransmitters in CNS. For the next 2 years she had no attacks. Studies during treatment were all normal. 3 weeks after stopping treatment, she had a typical attack. Certain cases of chronic vomiting may respond to drugs which alter CNS neurotransmitters.
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Finkelstein, J., Matustik, C., Meyer, W. et al. 12 NEUROTRANSMITTER MEDIATED RECURRENT VOMITING IN A TEENAGE GIRL. Pediatr Res 15 (Suppl 4), 441 (1981). https://doi.org/10.1203/00006450-198104001-00021
Issue date:
DOI: https://doi.org/10.1203/00006450-198104001-00021
