Abdominal Migraine

Descriptive text is not available for this imageBASICS

DESCRIPTION

Paroxysmal disorder of an acute onset, severe, noncolicky, periumbilical, or diffuse abdominal pain accompanied variably with nausea, vomiting, anorexia, headache, and pallor, lasting ≥1 hour

EPIDEMIOLOGY

Incidence

  • Occurs mostly in children; mean onset at age 7 years (3 to 10 years)
  • Peaks at 5 and 10 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

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.
  • Commonly specific high-amine food triggers are present: citrus fruits, chocolate, cheese, eggplant, mushrooms, salami, and ham.
  • Abdominal migraine shares pathophysiologic mechanisms and clinical characteristics with cyclic vomiting syndrome and migraine headaches.

RISK FACTORS

Genetics

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

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