Diseases and Conditions › Pediatric Neurology › Abdominal Migraine

Abdominal Migraine

Jagdish Kathwate*, Sonal Bhatia**

*MD Pediatrics. Assistant Professor, Government Medical College, Aurangabad, India, **MD Pediatrics, Fellowship, Pediatric Neurology, SUNY Downstate Medical Center
First Created: 08/01/2015 Last Updated: 02/04/2016

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Patient Education

What is an abdominal migraine?

Abdominal is a variant of migraine headaches. It usually occurs in children who have a family history of migraines. Abdominal migraines are rare in adults, but about 2% of all children may get abdominal migraines. Females are more affected than males. Children that experience abdominal migraines typically develop migraine headaches when they get older. Although abdominal migraines are in the migraine family, the pain occurs in the belly. Usually, it's near the navel or midline. Abdominal migraines frequently occur as a reaction to a migraine trigger. They can cause severe stomach pain, nausea, abdominal cramping, and often vomiting.

What are causes abdominal migraines?

The exact cause of abdominal migraines hasn't been discovered, but one theory is that abdominal migraines are caused by changes in two chemicals, histamine, and serotonin. Both of these occur naturally in the body. The chemical changes could contribute to both migraine headaches and abdominal pain. Experts now believe that daily stress and anxiety can cause fluctuations in these body chemicals. There is increasing support for the theory that unexplained abdominal pain may have a psychological trigger.

What are the signs and symptoms of abdominal migraines?

Symptoms of abdominal migraines may include

Acute, severe, midline abdominal pain that is associated with nausea

Vomiting

Paleness

The abdominal pain may last for as short as one hour or as long as three days. Migraine headaches are generally preceded by an "aura" by which the migraine sufferer can sense that a headache is coming on. Abdominal migraines, though, are frequently sudden and quite severe. They can occur without any warning signs and can increase anxiety in the person who gets them.

How are abdominal migraines treated?

Specific treatment for abdominal migraines has not yet been established. Because little is known about treating abdominal migraines, doctors may treat them like other migraines. For some patients, certain serotonin blockers and tricyclic antidepressants may be useful for treating abdominal migraines. Doctors have had some success in treating older children with nasal sumatriptan, which is a drug in the triptan class. However, the triptans used for migraine headaches have not been approved for use in children.

Can abdominal migraines be prevented?

With appropriate education, children and adults with abdominal migraines may be able to figure out their personal triggers. For example, sometimes food such as chocolate or Chinese food that contains monosodium glutamate might increase the chance of abdominal migraines. Avoiding these foods may be useful for some. Many people, though, have no food triggers for abdominal migraines.

A STRESS mnemonic designed by the authors of the article titled ‘Abdominal migraine in children: Is it all in their heads?’ can be a useful educational tool for parents of children with AM.²⁴ This is summarized in Table 3 – STRESS mnemonic for parent and patient education

S (Stress management)	-Avoid stressful and anxious situations -Allow your child to have downtime during highly stressful situations
T (Travel tips)	-Anticipate possible triggers during travel-motion sickness, altitude and temperature changes, disrupted sleep, “wrong foods”, dehydration -During travel, ensure that your child gets adequate rest and sleep with a healthy and regular diet
R (Rest)	-Avoid irregular sleep patterns (either deprivation or excess sleep) -During an attack, use a dark and quiet room to rest
E (Emergency signs requiring medical attention)	-Fever -Unexplained weight changes -Persistent abdominal pain, vomiting, diarrhea in between the attacks -Mouth ulcers, back pain
S (Sparkling lights)	-Avoid prolonged exposure to strobes/flashing/bright flickering lights such as the TV, computer or cellphone screen
S (snacks to avoid)	-Caffeine containing foods: soda, chocolate, coffee, tea -Aged, overcooked and processed meats; aged cheeses, dried and canned fish -Condiments: meat extracts, monosodium glutamate, soy sauce, vinegar -Fruits: ripening bananas, dates, figs, grapes, lemon, lime, orange, pineapple, plum, raspberry -Snack foods: Cheese or spicy flavored snack foods, coconut, peanut, sesame seeds, walnut (black) -Vegetables: Eggplant, cauliflower, mushrooms, olives, spinach, tomato -Fish: Mackerel, salami, salmon, dried sardines -Dairy products: Cheese-cheddar, gouda, mozzarella, parmesan, provolone, romano, Swiss

References

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