Abdominal Migraine

Basics

Description

Paroxysmal disorder of an acute onset, severe, noncolicky, periumbilical, or diffuse abdominal pain accompanied variably with nausea, vomiting, anorexia, headache, and pallor

Epidemiology

Incidence

  • Occurs mostly in children; mean onset at age 7 years (3 to 10 years)
  • Peak symptoms 10 to 12 years of age
  • More common in girls (3:2)

Prevalence

  • May affect as many as 1–4% of children at some point in their lives
  • Declining frequency toward adulthood

Risk Factors

Genetics

Parents of affected children often have history of migraine headaches and motion sickness.

Etiology

  • May involve neuronal activity originating in the hypothalamus with involvement of the cortex and autonomic nervous system
  • Serotonin is implicated and blockade of serotonin receptors may prevent abdominal migraine.
  • Recent studies suggest involvement of local intestinal vasomotor factors.
  • Abdominal migraine shares pathophysiologic mechanisms and clinical characteristics with cyclic vomiting syndrome and migraine headaches.

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