Criteria:
(1) >= 3 periods of intense, acute nausea and unremitting vomiting that last for hours to days.
(2) These episodes are separated by asymptomatic intervals lasting weeks or months.
Exclusions - no evidence of:
(1) metabolic disorder (pheochromocytoma, adrenal insufficiency, diabetes mellitus, urea cycle enzyme deficiency, medium-chain acyl coenzyme A dehydrogenase deficiency, propionic acidemia, porphyria)
(2) gastrointestinal disease (bowel obstruction, chronic bowel pseudo-obstruction, peptic ulcer disease)
(3) CNS disease (brain stem tumor, familial dysautonomia)
(4) pancreatitis
(5) obstructive uropathy
(6) viral infection associated with nausea and vomiting
Common features:
(1) Most patients are 2-7 years old, but patients may range from infants to adults.
(2) The condition may affect several family members.
(3) Patients may also complain of migraine headaches, motion sickness or dysfunctional bowel disorders.
(4) Episodes tend to start at a similar time and have the same duration.
(5) Many patients have an identifiable triggering event.
