Hyperekplexia (startle disease) is a rare non-epileptic neurological entity resulting from gene mutation. The onset of this disorder is usually in infancy, but can be delayed until early adulthood. Patients with this disorder usually have normal mental development. Patients with hyperekplexia may present with symptoms ranging from sub-syndromal anxiety, to symptoms of syndromal anxiety disorder. This case report is about two siblings with hyperekplexia, in whom phobic anxiety disorder was a prominent manifestation.

In this case report, a middle aged lady presenting with persistent vomiting of 12 years duration, not responding to conventional management and showing dramatic response to combinations of low dose Imipramine and Trifluperazine is discussed. Method: In our case, a middle aged lady presenting with chronic, recurrent episodes of severe vomiting for approximately 12 years with poor treatment outcome was evaluated and treated with low dose imipramine and Trifluperazine, which was found to be highly effective. Results: Low dose Trifluperazine and imipramine is effective in the treatment of cyclic vomiting syndrome. Conclusion: Cyclic Vomiting Syndrome is often missed and appropriate psychiatric intervention gives a better outcome.