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Based on these studies that describe dysautonomic characteristics in patients with CVS, researchers have posited the hypothesis that this imbalance can cause patients to be more susceptible to producing an uncontrolled response to central emetic signals.27 During the inter-episodic phase of the disease, patients with CVS can present with accelerated gastric emptying in up to 59% of cases.30 In fact, accelerated gastric emptying can be an indirect marker of the underlying autonomic dysregulation in CVS

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As no plasma levels of methadone and metabolites were measured this effect cannot be excluded