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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Medical
Satisfied Customers: 9000
Experience:  Neurologist/Internist with academic and clinical experience.
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In my early 70's and apparently developed CVS. I have been

Customer Question

In my early 70's and apparently developed CVS. I have been prescribed anti depression & anti nausea medication. I understand I should avoid cheese and chocolate. Poor me !
Your on-line info was very helpful but I am wondering if there is anything else I should know. Jackie
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Frank replied 1 year ago.
Hello Welcome to JA. CVS is a problem of brainstem function, specifically an area of the brainstem called the CTZ, or chemotherapeutic trigger zone, where the blood brain barrier is denuded or sparse. This is an area at the base of the 4th Ventricle in the brain, an area embryologically and through evolution designed to sense toxic compounds when they get in the blood stream, so a cycle of vomiting and nausea can start to get rid of the toxic agent. This prevented the carnivore from eating bad decayed meat, etc. Not much is known about this disease, but it is presumed that the CTZ area is misfiring and sending signals to the stomach to cause excessive nausea in a circadian pattern, and we know that it can be better controlled with certain medications, like Zofran (ondansetron) or amitryptyline (Elavil). Certain antiepileptic drugs like gabapentin or topiramate have been found effective as well. There are "toxic compounds" especially foods containing tyramine, like aged cheeses, red wine, and aged meats containing nitrates that are to be avoided.Also there seems to be in certain patients a family history, especially being carried along in Maternal Lines. This is very interesting because it suggests that this disease might be a mitochondrial disorder, a special group of diseases where the problem is protein regulation in forming RNA and DNA in the mitochondria. This is new research, but if true may lead to a whole different class of medications to change the genetic structure of the mitochondrial DNA in a way to reverse the disease entirely. So that is about all I have on CVS. Please get back to me to discuss this further. Ask Questions and I will reply. Or if satisfied, please remember to rate this service by clicking on the rating stars as that is how I am compensated for this work. Thanks *****