Abdominal Migraine
Causes, Symptoms, Diagnosis and Treatment

Abdominal Migraine, also called stomach migraine, is a not too well understood condition, more often found in children, but can occur at any age. It is characterized by bout of repeated abdominal pain, vomiting and pale discoloration of the skin. It is a condition seen in those with family history of migraine.

abdominal migraine in a child

What Is Abdominal Migraine?

Abdominal migraine is a common type of migraine attack that doesn’t affect your head, but manifests as mild to severe central upper abdominal pain. Often, an abdominal migraine will cause facial flushing, pale coloration, and episodes of vomiting.

Abdominal migraines are more common in children than adults, and impacts about 4% of children. Young girls under the age of 12 have more occurrences of abdominal migraines than young boys.

 Migraine pain may be preceded by a feeling of listlessness, drowsiness, and lethargy. Migraine-like visual symptoms also present as flashing lights, seeing dots and lines, and a desire to withdraw from bright light altogether.

Triggers and Causes of Abdominal Migraine

The exact cause of abdominal migraines is not known. Like migraine headaches, abdominal migraines may be the result of chemical changes in the body which originate in specific parts of the brain, namely the amygdala, area post-trema and hippocampus.

A high incidence of abdominal migraine has been reported in individuals with neurofibromatosis, especially type one. It is a very common cause of abdominal pain in these patients.

Triggers of abdominal migraine include:

  • Emotional or severe physical stress, anger, grief, depression
  • Extreme temperatures
  • Bright flickering lights, even those associated with watching television or computer screens for a long periods
  • Consumption of chocolate, mono sodium glutamate, fizzy drinks, caffeine, cheese, alcohol, red wine, citrus fruit, and a host of other food items.
  • Infrequent meals, or periods of starvation
  • Hormonal changes occurring during menses, or menopause or during HRT being started or stopped

The best way to figure out if any of the above triggers impact you is to retroactively track your actions and behaviors in the days leading up to a migraine. 

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

Like those with migraine, visual disturbances may precede onset. As well, sufferers may experience 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 withdrawn, alter their sleep pattern and experience sensitivity to light and sound. Abdominal migraine pain typically starts in the morning but can be severe enough to interfere with the sufferer’s daily activities.

Between migraine episodes, most people will feel totally free from abdominal pain. It is only during these 2- to 72-hour episodes that the cascade of symptoms which precede and accompany abdominal migraines are present. 

Diagnosis Of Abdominal Migraine

Diagnosing abdominal migraines is not done with tests. Rather, diagnosis is offered based on a careful review of the patient’s history and an abdominal scan to ensure there aren’t other problems in the abdomen that may be causing the symptoms.

Abdominal migraine pain could be anywhere in the abdomen, but most often occurs around the umbilicus, or upper abdomen, and lasts for several hours, followed by a period of no symptoms, followed again by several more hours of symptoms. Abdominal migraine sufferers usually have a family history of migraines, often in the mother.

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

Visual Evoked Response (VER) tests the patient’s response to red and white flash light, and provides an indication of the presence of abdominal migraines in a child. Those with abdominal migraines display a fast wave form response to flashing light than other children.

It is important to conduct other basic tests to eliminate the possibility that another physical problem is causing the child’s symptoms. Recurrent vomiting and abdominal pain can also indicate more serious conditions like bowel obstruction or the presence of an infection.

The diagnosis of abdominal migraine is essentially a medical process of elimination.

Treatment Of Abdominal Migraine

When the first symptoms of an abdominal migraine begin to surface, there is very little that can be done to stop it, which is part of what makes migraines so difficult to manage. The most reliable prescribed remedy to provide any sort of relief is simply adequate rest. Lying in a dark, quiet place often provides relief.

Like migraine headaches, the best treatment for abdominal migraines is prevention. Medications that have been used with success in the treatment of abdominal migraine include:

  • Paracetamol and or ibuprofen which may help take the edge off the abdominal pain.
  • Intra nasal sumatriptan - imigraine has been found to help shorten attacks in some individuals

If abdominal migraine is frequent and troublesome, sufferers could be placed on long-term preventive medications for up to six months and then stopped. This treatment is rare, as most migraines come for a short period of time with months or even years between attacks.

The commonly used long-term preventive medications include:

Most children who suffer from abdominal migraine will outgrow this disorder, but may develop migraine headaches as an adult. 

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