Low Prevalence of Definite Migraine in Childhood-Onset Cyclic Vomiting Syndrome: A Retrospective Cohort Study from Southern Iran
| Author | Mahmood Haghighat | en |
| Author | Seyed Mohsen Dehghani | en |
| Author | Sara Mostafavi | en |
| Author | Fateme Ziyaee | en |
| Author | Narges Ansary | en |
| Author | Zahra Heidari | en |
| Author | Asma Fazel | en |
| Author | Amir Mohammad Ghiasi Nezhad | en |
| Author | Mahsa Rouhafshari | en |
| Author | Masoume Pandi | en |
| Author | Maryam Moradian Shahrebabaki | en |
| Author | Zahra Radaei | en |
| Orcid | Mahmood Haghighat [0000-0002-0435-7643] | en |
| Orcid | Seyed Mohsen Dehghani [0000-0001-5930-0110] | en |
| Orcid | Sara Mostafavi [0000-0002-5635-8912] | en |
| Orcid | Fateme Ziyaee [0000-0001-6651-7414] | en |
| Orcid | Narges Ansary [0000-0003-2677-9350] | en |
| Orcid | Zahra Heidari [0000-0002-7993-2681] | en |
| Orcid | Asma Fazel [0000-0002-3760-7717] | en |
| Orcid | Mahsa Rouhafshari [0009-0002-7651-5265] | en |
| Orcid | Maryam Moradian Shahrebabaki [0009-0000-4782-972X] | en |
| Orcid | Zahra Radaei [0009-0004-8018-0028] | en |
| Issued Date | 2026-08-31 | en |
| Abstract | Background: Cyclic vomiting syndrome (CVS) frequently overlaps with migraine; however, clinic-based data from the Middle East that use current standardized criteria remain limited. Objectives: We characterized age at diagnosis and follow-up duration in an unselected CVS population and compared patients with and without definite migraine according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Secondary objectives were to describe patterns of prophylactic medication use by age group and to explore their relationship with migraine status. Methods: We conducted a retrospective chart review of patients with a physician-documented CVS diagnosis who were referred during the study period to the Pediatric Gastroenterology clinics at Shiraz University of Medical Sciences in southern Iran. Migraine was classified as definite when the treating clinicians had applied the ICHD-3 criteria. Time since diagnosis was calculated as the current age minus the age at the initial CVS diagnosis. Continuous variables were compared using the Mann-Whitney U test, and categorical variables were compared using the χ2 or Fisher exact test. Results: Of 472 patients analyzed, 68 (14.4%) had definite migraine and 404 (85.6%) did not. Patients with migraine were significantly older at the last clinic visit (median, 18 vs 16 years; P < 0.001), whereas age at CVS diagnosis was similar between the groups (median, 5.5 vs 5.0 years; P = 0.243). Follow-up duration was significantly longer among patients with definite migraine (median, 12 vs 10 years; P = 0.028). A binary threshold of > 8 years indicated higher odds of extended follow-up among patients with migraine (80.9% vs 67.7%; OR, 2.01; 95% CI, 1.06 - 3.82). Prophylaxis was recorded in 295 patients (62.5%) and was more common among those aged ≥ 18 years than among those aged < 18 years (69.5% vs 58.4%; P = 0.016), with no overall association with migraine (16.6% vs 10.7%; P = 0.078). Conclusions: In this large consecutive cohort of childhood-onset CVS, definite migraine according to ICHD-3 criteria was more frequently identified in older patients, although age at the initial CVS diagnosis did not differ between groups. Longer follow-up among patients with definite migraine largely reflected older current age rather than earlier disease onset. Prophylactic treatment was more common in adulthood, without a clear statistical association with migraine status. These findings highlight the value of routine, age-appropriate migraine screening in CVS care and support future time-to-event analyses to disentangle aging from follow-up duration. | en |
| DOI | https://doi.org/10.5812/jcp-171508 | en |
| URI | https://brieflands.com/journals/jcp/articles/171508 | en |
| Keyword | Cyclic Vomiting Syndrome | en |
| Keyword | Migraine | en |
| Keyword | International Classification of Headache Disorders | en |
| Keyword | Pediatrics | en |
| Keyword | Retrospective Studies | en |
| Keyword | Preventive Medicine | en |
| Publisher | Brieflands | en |
| Title | Low Prevalence of Definite Migraine in Childhood-Onset Cyclic Vomiting Syndrome: A Retrospective Cohort Study from Southern Iran | en |
| Type | Research Article | en |
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