Greene Kaitlin A, Gelfand Amy A
Division of Pediatric Neurology, Oregon Health and Science University, Portland, Oregon, USA.
Child and Adolescent Headache Program, University of California, San Francisco, California, USA.
Neurogastroenterol Motil. 2025 Mar;37(3):e14899. doi: 10.1111/nmo.14899. Epub 2024 Aug 12.
Cyclic vomiting syndrome (CVS) is identified as one of the "episodic syndromes that may be associated with migraine," along with benign paroxysmal torticollis, benign paroxysmal vertigo, and abdominal migraine. It has been proposed that CVS and migraine may share pathophysiologic mechanisms of hypothalamic activation and altered dopaminergic signaling, and impaired sensorimotor intrinsic connectivity. The past decade has brought groundbreaking advances in the treatment of migraine and other headache disorders. While many of these therapies have yet to be studied in episodic syndromes associated with migraine including CVS and abdominal migraine, the potential shared pathophysiology among these conditions suggests that use of migraine-specific treatments may have a beneficial role even in those for whom headache is not the primary symptom.
This manuscript highlights newer therapies in migraine. Calcitonin gene-related peptide (CGRP) and its relation to migraine pathophysiology and the therapies that target the CGRP pathway, as well as a 5HT1F receptor agonist and neuromodulation devices used to treat migraine are briefly discussed as they may potentially prove to be useful in the future treatment of CVS.
周期性呕吐综合征（CVS）与良性阵发性斜颈、良性阵发性眩晕及腹型偏头痛一同被认定为“可能与偏头痛相关的发作性综合征”。有人提出，CVS和偏头痛可能共享下丘脑激活、多巴胺能信号改变及感觉运动内在连接受损的病理生理机制。在过去十年中，偏头痛及其他头痛疾病的治疗取得了突破性进展。虽然其中许多疗法尚未在包括CVS和腹型偏头痛在内的与偏头痛相关的发作性综合征中进行研究，但这些病症之间潜在的共同病理生理学表明，即使对于那些头痛并非主要症状的患者，使用偏头痛特异性治疗可能也有益处。
本文着重介绍偏头痛的新型疗法。降钙素基因相关肽（CGRP）及其与偏头痛病理生理学的关系、靶向CGRP途径的疗法，以及用于治疗偏头痛的5HT1F受体激动剂和神经调节装置都将被简要讨论，因为它们可能在未来CVS的治疗中证明有用。
