2025 ICD-10-CM code G43.A
Effective Date: N/A Diseases of the nervous system - Episodic and paroxysmal disorders 6 Feed
Cyclical vomiting associated with migraine.
Medical necessity for treatment is based on the impact of symptoms on the patient's quality of life and the potential for complications such as dehydration. Treatment aims to reduce the frequency and severity of episodes and manage associated symptoms.
Clinicians should consider medical history, symptoms, a thorough physical and neurological examination for diagnosis. Additional tests, such as upper endoscopy, ultrasound, and GI motility studies, may be done to rule out other GI disorders, and lab studies like blood and urine tests to rule out other metabolic conditions. Treatment involves managing nausea and vomiting with antiemetics and antacids, abdominal pain with NSAIDs, and migraine symptoms with anti-migraine medications.
In simple words: Cyclical vomiting in migraine is a condition where a person experiences repeated episodes of intense nausea and vomiting, along with migraine symptoms.These episodes can last for a period ranging from hours to days, with normal periods in between.Treatment may involve medications to prevent migraine, reduce nausea and vomiting, and manage associated symptoms like stomach pain.
Cyclical vomiting in migraine is characterized by recurrent episodes of severe nausea and vomiting, often accompanied by migraine symptoms. These episodes can last from a few hours to several days, with symptom-free periods in between.The vomiting is often intense and can be projectile. Associated symptoms can include abdominal pain, sweating, pallor, fever, fatigue, headache, photophobia, phonophobia, and dizziness/vertigo. The episodes frequently begin in the morning, and the vomitus may appear green or yellow.While the nausea can be more intense than the vomiting itself, it isn't always relieved by vomiting.Diagnosis is based on medical history, symptoms, physical examination, and neurological evaluation.Further investigations like upper endoscopy, ultrasound, and GI motility studies may be conducted to rule out other gastrointestinal disorders. Laboratory tests may also be performed. Treatment options vary and include anti-migraine medications (amitriptyline, cyproheptadine, propranolol), antiemetics, antacids, NSAIDs, antidepressants, and anticonvulsants.Supportive care with fluid and electrolyte replacement is important.Some patients may benefit from Coenzyme Q10, L-carnitine, and riboflavin supplements.Identifying and avoiding triggers like stress, certain foods, lack of sleep, and infections is recommended.
Example 1: A 7-year-old child experiences recurrent episodes of severe vomiting and nausea, lasting for 2 days every few weeks. These episodes are associated with headache, sensitivity to light, and abdominal pain., A 32-year-old woman presents with a history of repeated vomiting episodes, occurring approximately once a month and lasting for 12 hours. She experiences intense nausea, retching, and abdominal pain during these episodes. She also reports sensitivity to light and sound., A 45-year-old man reports experiencing episodes of intense nausea, vomiting, and abdominal pain roughly every two months.The episodes last 24-36 hours, and he has a known history of migraine headaches.
Documentation should include frequency, duration, and severity of vomiting episodes; associated symptoms (e.g., headache, abdominal pain, photophobia, phonophobia); triggers; and response to treatment. Details of the physical and neurological examinations should also be documented.
- Specialties:Neurology, Gastroenterology, Pediatrics
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital