A Neurologist’s View of Nausea and Vomiting
Migraine. Classic migraine attacks are characterised by nausea, and also by gastric stasis. Intense pain may contribute to gastric stasis, which may be the cause of the sensation of nausea, and may or may not lead to vomiting. Moreover, it is possible that the effect of analgesics is increased by administration of an anti-emetic.
Raised intracranial pressure. Vomiting may be sudden and forceful, but more often is preceded by severe nausea. Relief of raised pressure (e.g. surgery, dexamethasone) relieves sickness within a few days.
Low brain-stem focal gliomas. These may cause severe and persistent vomiting, with or without nausea, in the early stages, and without raised intracranial pressure, pointing to a vomiting centre in man localized in the low medulla.
Vestibular disorders. Vomiting is a common feature in ear disease, Meniere’s disease, vestibular neuronitis. Anticholinergic and antihistaminic, but not antidopaminergic, drugs give relief.
KeywordsDopamine Amphetamine Dystonia Nial Pyridoxine
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