What are the other Names for this Condition? (Also known as/Synonyms)

• AM (Abdominal Migraine)

What is Abdominal Migraine? (Definition/Background Information)

• Abdominal Migraine (AM) is described as a form of recurrent gastrointestinal disturbance (RGD) predominantly affecting children, characterized by recurrent episodes of severe (cramping) abdominal pain, often accompanied by nausea, vomiting, flushing of the face, and sometimes headache. This condition is considered a variant of migraine that affects children, although it can persist into adulthood. The exact cause of this form of migraine is unknown
• The signs and symptoms of Abdominal Migraines typically include recurrent, intense abdominal pain that is usually located around the navel. This pain can be severe and cramp-like, often accompanied by nausea, vomiting, and loss of appetite. Some individuals with Abdominal Migraines may also experience a throbbing headache, light sensitivity, or other typical migraine symptoms during or after the abdominal episode
• Diagnosing Abdominal Migraine can be challenging, as its symptoms can overlap with various gastrointestinal disorders. A healthcare provider will typically consider the individual’s medical history, family history of migraines, and the presence of typical symptoms such as recurrent abdominal pain and associated nausea or vomiting. Imaging studies and blood tests to rule out other underlying medical conditions may be undertaken as necessary
• Treatment for Abdominal Migraines focuses on managing and preventing episodes. This may involve lifestyle modifications, such as identifying and avoiding triggers, maintaining a regular sleep schedule, and managing stress. Medications, such as antinausea drugs or preventive migraine medications, may be prescribed to reduce the frequency and severity of episodes. Lifestyle changes and dietary adjustments may also be recommended to help prevent or manage Abdominal Migraines
• The prognosis for individuals with Abdominal Migraines is generally favorable. Many children with this condition outgrow it as they reach adolescence, and the frequency and severity of episodes tend to decrease with age. However, it can persist into adulthood in some cases. Effective management and early intervention can significantly improve the quality of life for individuals with Abdominal Migraines, allowing them to lead normal, healthy lives

Who gets Abdominal Migraine? (Age and Sex Distribution)

• Abdominal Migraine most commonly affects children and adolescents, with symptoms often appearing between the ages of 3 and 10
• It occurs in both males and females, though some studies suggest a slightly higher prevalence in girls
• Worldwide, no racial or ethnic group preference is generally noted

What are the Risk Factors for Abdominal Migraine? (Predisposing Factors)

The exact causes of Abdominal Migraine are unclear, but several factors may increase the risk, including:

• A family history of migraines or Abdominal Migraines
• A personal history of migraines
• Psychological stress

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Abdominal Migraine? (Etiology)

The exact cause of Abdominal Migraine is still unknown, but it is thought to involve genetic factors, abnormal brain activity, and changes in the gut-brain connection. It is also believed that hormonal fluctuations may play a role in its development.

What are the Signs and Symptoms of Abdominal Migraine?

Abdominal Migraine is characterized by recurrent episodes of severe abdominal pain that can last for hours to days. The pain may be severe enough to disrupt the child's normal activities. The signs and symptoms may last anywhere from 2 hours to up to 3 days. The child may remain completely symptomless between the attacks. The condition is also characterized by the absence of headaches during the episodic attacks

Other common signs and symptoms include:

• Nausea and vomiting
• Loss of appetite
• Pallor (pale skin)

During an episode, the child may want to lie down in a quiet, dark room and avoid any triggers that worsen the symptoms.

How is Abdominal Migraine Diagnosed?

Diagnosing Abdominal Migraine can be challenging, as it often involves ruling out other potential causes of abdominal pain.

• A thorough medical history, physical examination, and blood tests may be performed
• An exclusion of conditions that may affect the gastrointestinal tract or kidneys is established via physical exams, medical history evaluation, and suitable imaging studies and procedures
• In case a headache is present during the abdominal signs and symptoms, the healthcare provider may evaluate the child for “migraine without aura”

The criteria for diagnosis of Abdominal Migraine as outlined by the International Headache Society (IHS) is given below:

• At least five attacks of abdominal pain fulfilling all the criteria below
• Pain has at least two of the following three characteristics:
  • Midline location, periumbilical or poorly localized
  • Dull or “just sore” quality
  • Moderate or severe intensity
• At least two of the following four associated symptoms or signs:
  • Anorexia
  • Nausea
  • Vomiting
  • Pallor
• Attacks last 2-72 hours when untreated or unsuccessfully treated

AND

• Complete freedom from symptoms between attacks
• Not attributed to another disorder

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Abdominal Migraine?

While Abdominal Migraine itself is not typically associated with serious complications, the condition can significantly impact a child's quality of life, causing missed school days and social limitations. Moreover, children with Abdominal Migraines may be more prone to developing migraine headaches later in life.

How is Abdominal Migraine Treated?

The treatment for Abdominal Migraine often involves a combination of lifestyle modifications and medications.

• Lifestyle changes may include identifying and avoiding triggers, maintaining a regular sleep schedule, and managing stress
• Medications such as pain relievers, anti-nausea drugs, and preventive migraine medications may be prescribed to manage symptoms and reduce the frequency of episodes

How can Abdominal Migraine be Prevented?

Preventing Abdominal Migraines may involve identifying and avoiding triggers, maintaining a healthy lifestyle, and sometimes using preventive medications as prescribed by a healthcare provider. Stress management techniques, adequate hydration, and a balanced diet can also contribute to prevention.

What is the Prognosis of Abdominal Migraine? (Outcomes/Resolutions)

The prognosis for Abdominal Migraine is generally positive.

• Many children outgrow the condition as they enter adolescence or adulthood
• Effective treatment can help manage symptoms and improve the quality of life for those affected

However, according to some studies, children with Abdominal Migraines are known to develop migraine headaches later in their lives.

Additional and Relevant Useful Information for Abdominal Migraine:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/neurological-institute/