1.6.1.2 Abdominal migraineHartmut Gobel2018-02-06T09:54:55+00:00
Description:
An idiopathic disorder seen mainly in children as recurrent attacks of moderate to severe midline abdominal pain, associated with vasomotor symptoms, nausea and vomiting, lasting 2-72 hours and with normality between episodes. Headache does not occur during these episodes.
Diagnostic criteria:
- At least five attacks of abdominal pain, fulfilling criteria B–D
- 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
- Complete freedom from symptoms between attacks
- Not attributed to another disorder1.
Note:
In particular, history and physical examination do not show signs of gastrointestinal or renal disease, or such disease has been ruled out by appropriate investigations.
Comments:
Pain of 1.6.1.2 Abdominal migraine is severe enough to interfere with normal daily activities.
In young children the presence of headache is often overlooked. A careful history of presence or absence of headache must be taken and, when headache or head pain during attacks is identified, a diagnosis of 1.1 Migraine without aura should be considered.
Children may find it difficult to distinguish anorexia from nausea. Pallor is often accompanied by dark shadows under the eyes. In a few patients, flushing is the predominant vasomotor phenomenon.
Most children with abdominal migraine will develop migraine headache later in life.