Disorders of the central and autonomic nervous systems as a cause for emesis in infants.

Vomiting in infants can be caused by a wide variety of neurological disorders. All involve stimulation of a central pattern generator for vomiting located in the brainstem, the nucleus tractus solitarius. This, in turn, projects to multiple motor nuclei involved in the vomiting reflex. The chemoreceptor trigger zone (the area postrema) in the floor of the fourth ventricle is a major afferent to the nucleus tractus solitarius that can be stimulated by pressure from hydrocephalus, closed head injuries, or tumors. Other neurological causes of vomiting discussed include migraine, epilepsy, and dysautonomia. The treatment of vomiting associated with nervous system disease may be very difficult unless the condition is acute and readily reversible.