Abdominal migraine

Abdominal migraine is a disorder primarily of children which presents with episodes of abdominal pain without an accompanying headache.[1][2] It is difficult to confirm the diagnosis as there are not a set of features that is specific and thus it can take time before the diagnosis is made.[3] The condition is rare in adults;[1] however, children diagnosed with abdominal migraines may have migraine headaches as adults.[4]

Signs and Symptoms

As with other types of migraines, there is no diagnostic test to identify abdominal migraines.[5] Diagnosis is based on symptoms, a family history of migraines, and eliminations of other possible causes.[6] Common migraine triggers may also trigger abdominal migraines.

Symptoms[6] [5] may include:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Headaches
  • Light sensitivity

Diagnosis

The diagnosis of abdominal migraines was once considered controversial[7] but is now accepted as a common cause of chronic abdominal pain in children.[8] Diagnostic criteria from the International Classification of Headache Disorders as of 2004 are:

A. At least 5 attacks fulfilling criteria B-D.
B. Attacks of abdominal pain lasting 1–72 hours (untreated or unsuccessfully treated)
C. Abdominal pain has all of the following characteristics:
1. midline location, periumbilical or poorly localized
2. dull or "just sore" quality
3. moderate or severe intensity
D. During abdominal pain at least 2 of the following:
1. loss of appetite
2. nausea
3. vomiting
4. pallor
E. Not attributed to another disorder[9]

Pathophysiology

Abdominal migraines are a type of functional pain.[10]

History

This condition was first described in 1921 by Buchanan.[11]

References
  1. Russell, G; Abu-Arafeh, I; Symon, DN (2002). "Abdominal migraine: evidence for existence and treatment options". Paediatric Drugs. 4 (1): 1–8. doi:10.2165/00128072-200204010-00001. PMID 11817981.
  2. Cuvellier, JC; Lépine, A (Jan 2010). "Childhood periodic syndromes". Pediatric Neurology. 42 (1): 1–11. doi:10.1016/j.pediatrneurol.2009.07.001. PMID 20004856.
  3. Catto-Smith, AG; Ranuh, R (Nov 2003). "Abdominal migraine and cyclical vomiting". Seminars in Pediatric Surgery. 12 (4): 254–8. doi:10.1053/j.sempedsurg.2003.08.006. PMID 14655164.
  4. "Headache: Hope through research". NINDS. April 2016.
  5. "Abdominal Migraine". American Migraine Foundation. Retrieved 2020-08-19.
  6. "Abdominal Migraine: Symptoms, Diagnosis & Treatment > Condition at Yale Medicine". Yale Medicine. Retrieved 2020-08-19.
  7. Davidoff, Robert A. (2002). Migraine : manifestations, pathogenesis, and management (2nd ed.). Oxford [u.a.]: Oxford Univ. Press. p. 81. ISBN 9780195137057.
  8. Mani, Jyoti; Madani, Shailender (2018-04-24). "Pediatric abdominal migraine: current perspectives on a lesser known entity". Pediatric Health, Medicine and Therapeutics. 9: 47–58. doi:10.2147/PHMT.S127210. ISSN 1179-9927. PMC 5923275. PMID 29733088.
  9. Headache Classification Subcommittee of the International Headache Society (2004). "The International Classification of Headache Disorders, 2nd Edition" (PDF). Cephalalgia. Oxford, England: Blackwell Publishing. 24 (Supplement 1). ISSN 0333-1024. Archived from the original (PDF) on October 30, 2007. Retrieved 4 September 2009.
  10. Noe, JD; Li, BU (May 2009). "Navigating recurrent abdominal pain through clinical clues, red flags, and initial testing". Pediatric Annals. 38 (5): 259–66. PMID 19476298.
  11. Tepper, edited by Stewart J. Tepper, Deborah E. (2011-08-22). The Cleveland Clinic manual of headache therapy. New York: Springer. p. 96. ISBN 9781461401780.CS1 maint: extra text: authors list (link)
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