Abdominal Migraine

Abdominal migraine is a not well understood and often ignored cause of abdominal pain in millions of people worldwide.

It is also called Tummy Migraine, Non – headache migraine, and may be associated with cyclic vomiting syndrome (CVS). Abdominal migraine is a totally different entity from recurrent abdominal pain syndrome

It affects both adults and children, though much more common in children before the age of 12, with peak incidence at three and half years of age.

It is also more common in girls.

It is thought that this illness strongly related to migraine originates from an area of the brain called area post-trema. It is due to a disordered intestinal motility triggered by abnormal brain waves.

Symptoms of Abdominal Migraine

Abdominal migraine typically causes recurrent attacks of central abdominal pain, usually around the umbilicus or belly button, lasting for several hours with associated nausea, vomiting and occasionally one sided headache.

The sufferer may become pale and the pulse may be difficult to feel, or even run very slowly. They may also become very flushed.

Like those with migraine, there may be a preceding aura of visual disturbance, flashing lights, numbness or tingling sensation around the mouth, arm or a side of the body, slurred speech, muscle weakness or even paralysis.

The child or adult may become emotionally with drawn, with altered sleep pattern. There is associated dislike or sensitivity to light and sound too. The pain typically starts in the morning. It is so serious to interfere with day to day life.

In between episodes, they are usually totally free from abdominal pain and feel okay again. The pain typically last for about 2 - 6 hours and may keep re-occurring for the next three to four days with symptoms free interval.

Diagnosis of Abdominal Migraine

The diagnosis is suspected from a careful history and some form of imaging (scan) may help to shed more light on the likelihood of symptoms being due to abdominal migraine.

The history is usually typical. Recurrent attacks of abdominal pain. Pain could be any where in the abdomen, but most often around the umbilicus, or upper abdomen lasting for hours with symptoms free period in between.

There is usually a family history of migraine, often in the mother.

An EEG (brain wave scan called electro-encephalography) will demonstrate patterns suggestive of epilepsy.

Visual Evoked Response (VER) test to red and white flash light may give further indication of the presence of abdominal migraine in a child. Those with abdominal migraine display a fast wave form response to flashing light than normal children.

It is important to conduct other basic tests to confirm that the cause of a child or indeed adult’s recurrent vomiting and abdominal pain is not some very serious and potentially fatal conditions like bowel obstruction or some infections.

The diagnosis of abdominal migraine is one of exclusion.

Treatment of Abdominal Migraine

Reassurance and rest may help more than medications. Lying in a dark quiet place has provided relief for some.

Like migraine, the best treatment is prevention. Triggers of abdominal migraine are more or less the same for migraine. These include stress, extreme of temperatures, bright flickering lights associated with watching television or computer screens for a long time, consumption of chocolate, monosodium glutamate, fizzy drinks, caffeine, cheese, and a host of other food items.

Individuals should study and note things or food items that triggers attack in them and avoid these.

Common medications like paracetamol and or ibuprofen may help take off the abdominal pain.

If abdominal migraine is frequent and troublesome, sufferers could be placed on long term preventive medications for up to six months and then stopped. Most often, once there is no attack for a long tine, and triggers are avoided, one could lead an attack free life for a very long time.

The commonly used long-term preventive medications include:

Cyproheptadine



Propanolol



Fluoxetine

Most children out grow this disorder and may even develop migraine as adult.







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