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- Abdominal migraine in children facts
- What is abdominal migraine?
- What causes abdominal migraine?
- What are the symptoms of abdominal migraine?
- How is abdominal migraine diagnosed?
- What is the treatment of abdominal migraine?
- Medications to treat abdominal migraine
- What is the prognosis for abdominal migraine?
Abdominal migraine in children facts
- Abdominal migraine is believed to be a variant of migraine that is common in children but rare in adults.
- Abdominal migraine is characterized by pain in the center of the abdomen that may be severe.
- Symptoms can last for one hour or up to a several days.
- Nausea and vomiting may be associated with the pain.
- Sleep typically brings relief from abdominal migraine. Medications used to treat classic migraine can also be effective, although there is no single treatment that is known to be effective in all patients.
- Most children with abdominal migraine have a family history of migraine, and most go on to develop migraine as adults.
- The exact cause of abdominal migraine is poorly understood. It may be related to both neurologic and endocrinologic (hormone) factors.
- The diagnosis of abdominal migraine can be difficult, and depends upon ruling out other potential causes for the abdominal pain and symptoms. There is no one diagnostic test that confirms the diagnosis.
What is abdominal migraine?
Like adults, children can develop migraines. This can be the same type of condition seen in adults, which is typically occurs with a headache, and is sometimes preceded by an aura. Nausea, vomiting, and photophobia (decreased tolerance to light) can occur. Children also develop some unusual and atypical variations of migraine, not associated with headaches in particular, that are not usually observed in adults. Abdominal migraine is one of these variants.
Abdominal migraine is a condition thought to be related to migraine that is characterized by pain in the abdomen. It is often precipitated by the usual triggers of classic migraine. The pain can be severe, and nausea and vomiting can occur.
Abdominal migraine is rare in adults, but it has been estimated that up to 2% of all children may develop abdominal migraines. Children who have the condition usually go on to develop migraine headaches as adults. Girls are affected more frequently than boys. Abdominal migraine typically occurs for the first time between the ages of 2 and 10.
What causes abdominal migraine?
The cause of abdominal migraine is poorly understood. Abdominal migraine is thought by some researchers to be related to neurologic or endocrinologic changes and may be caused by alterations in the levels of serotonin and histamine in the body. Genetic factors may also be involved as the condition is more common in children who have a family history of migraine. About 60% of children with the condition have a positive family history for migraine.
Triggers for abdominal migraine have been described, similar to triggers for classic migraine. These include chocolate or nitrite-containing foods, stress, and anxiety.
What are the symptoms of abdominal migraine?
As mentioned, abdominal migraine causes pain in the abdomen that can be severe and debilitating. It is typically located in the middle portion of the belly, often around the umbilicus. Cramping, nausea, and vomiting can accompany the pain. Pallor (paleness) of the skin is often observed. There may not be associated headache. The symptoms are usually relieved by sleep and can last anywhere from one hour to several days.
How is abdominal migraine diagnosed?
Because of the frequent absence of headache, the condition can be difficult to diagnose, especially during the first episode. There is no specific test that can establish the diagnosis of abdominal migraine, so the diagnosis is based on exclusion of other conditions. Laboratory tests and imaging studies are usually directed to rule out other conditions that could be responsible for the symptoms. Electroencephalography (EEG) is sometimes done to rule out a seizure disorder as the cause of the symptoms.
What is the treatment for abdominal migraine?
The treatment of abdominal migraine has two components - to reduce symptoms of an acute attack and to prevent or lessen the severity of future episodes. Research to date has not provided sufficient data to firmly establish the role of any particular medication in either treating symptoms or preventing future episodes of abdominal migraine. Still, many patients respond to anti-migraine medications and other medications.
Medications to treat abdominal migraine
Types of medications that may be used to manage abdominal migraine include:
- Analgesic drugs, such as nonsteroidal anti-inflammatory medications (NSAIDs) or acetaminophen
- Sumatriptan (Imitrex, Alsuma), a member of the triptan class of drugs used to treat migraine in adults, has been used to treat some older children with abdominal migraine
- Tricyclic antidepressants and drugs that block the effects of serotonin have been used in some patients to decrease frequency of attacks.
- Valproic acid (Depakote), an antiseizure medication, has been used to treat abdominal migraine.
- Ergotamine medications, also used for adults with migraine, are used to treat some childhood variants of migraine.
- Low dose aspirin and low dose beta-blocker medications have been used over the long term in some patients in an attempt to diminish the frequency of future attacks.
- The antihistamine cyproheptadine has been shown to be effective in some children with migraine variants.
Other aspects of treatment may include the administration of intravenous fluids if vomiting is severe, and the use of sedatives or antiemetic drugs.
Treatment may also include advice to recognize and avoid triggers, if these are known. For example, if food triggers have been identified, these should be avoided, although not all those who experience abdominal migraine have identifiable food triggers. Stress management and relaxation programs may be of benefit to some.
What is the prognosis for abdominal migraine?
The prognosis for abdominal migraine is good; most children eventually stop having the attacks of abdominal pain. However, most children (about 70% in one study of 54 children) who have abdominal migraine go on to develop migraines in adulthood.
From 
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MedscapeReference.com. Childhood Migraine Variants.
Dignan F, Abu-Arafeh I, Russell G. The prognosis of childhood abdominal migraine. Arch Dis Child. 2001 May;84(5):415-8.
Top Abdominal Migraines in Children and Adults Related Articles
Abdominal Pain (Causes, Remedies, Treatment)
Abdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers.
Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination.
Treatment for abdominal pain depends upon the cause.
Abdominal Pain Pictures
Get the facts on the most common causes of abdominal pain. Learn the difference between a stomachache and more serious causes of abdominal pain. Diagnosis of abdominal pain is based on symptoms and the location of pain, like sharp pain in the lower abdomen.
Antidepressants
Depression medications or antidepressants are drugs prescribed for treating depression. There are several types of drug classes of antidepressants including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).
Side effects depend on the medication prescribed. Drug interactions, warnings and precautions, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
Anxiety
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Children's Abdominal Pain
Abdominal pain in children can be more than just a tummy ache. What are the common causes of abdominal pain in children? Learn about pediatric abdominal pain symptoms like rash, vomiting, diarrhea, and fever. What is the best treatment for stomach pain in children?
Cyclic Vomiting Syndrome (CVS)
Cyclic vomiting syndrome is a condition in which affected individuals have severe nausea and vomiting that come in cycles. Researchers believe that cyclic vomiting syndrome and migraine headaches are related. Triggers of cyclic vomiting syndrome are emotional stress and infections. People with cyclic vomiting syndrome are at an increased risk of dehydration. Cyclic vomiting syndrome is difficult to diagnose. Treatment varies from person to person, but is generally directed toward relief of the symptoms of the condition.cyproheptadine-oral
Periactin (brand name) cyproheptadine (generic name) is an antihistamine used to treat allergic reactions by blocking the histamines. The drug is used to for various types of allergic reactions including skin reactions. Off-label (non-FDA approved uses) include spasticity associated with spinal cord injury and preventing migraine headaches. There are numerous side effects of this medication and some include:
- Vomiting
- Diarrhea
- Constipation
- Cholestasis
- Hepatitis
- Eczema
- Itching
- Blurred vision
- Double Vision
- Ringing in the ears
- Urinary retention
Dosing, drug and supplement interactions, and pregnancy and breastfeeding safety should be reviewed prior to taking this drug.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms that include abdominal pain, bloating, increased gas (flatulence), abdominal cramping, diarrhea, constipation, and food intolerance.
Two new tests are now available that may help diagnose irritable bowel syndrome with diarrhea and constipation (IBS-M) irritable bowel syndrome with diarrhea (IBS-D), and irritable bowel syndrome with constipation (IBS-C). Treatment for IBS includes diet changes, medications, and other lifestyle changes to manage symptoms.
Irritable Bowel Syndrome (IBS) Triggers, Prevention
Irritable bowel syndrome (IBS) is a functional disease that can affect the quality of those who suffer from this condition. People with IBS can make lifestyle changes that may modify or control the number and severity of episodes. Certain foods, medications, and hormone levels may trigger IBS episodes, for example:
- Fatty foods
- Dairy products
- Eating foods in large quantities
- Foods that contain high levels of sorbitol
- Foods that produce intestinal gas (broccoli, onions, cabbage, and beans)
- Chocolate
- Caffeine
- Physiological stress
- Some antibiotics
- Some antidepressants
- Medicine with sorbitol
- Menstrual pain
Exercise, diet, and other lifestyle changes can decrease IBS flares, and prevent the number and severity of IBS episodes of diarrhea and constipation.
Irritable Bowel Syndrome in Children
Irritable bowel syndrome (IBS) in children is a functional gastrointestinal disorder with signs and symptoms of:
- Abdominal pain
- Bloating
- Diarrhea
- Constipation
The cause of IBS is unknown, however, certain foods, stress, anxiety, and depression may contribute to the symptoms of IBS. There is no cure for IBS in children; however, medications, dietary changes, and stress management may relieve symptoms.
Migraine
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known.Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping.
Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Nausea and Vomiting
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. There are numerous cases of nausea and vomiting. Some causes may not require medical treatment, for example, motion sickness, and other causes may require medical treatment by a doctor, for example, heart attack, lung infections, bronchitis, and pneumonia.
Some causes of nausea and vomiting may be life threatening, for example, heart attack, abdominal obstruction, and cancers.
Treatment of nausea and vomiting depends upon the cause.
Seizure vs Seizure Disorders Whats the difference
The differences between a seizure, epilepsy, and seizure disorders are confusing to many people. What makes it more confusing, is that they are not the same thing. A seizure begins suddenly, and is a symptom of another disease. When a seizure occurs there is uncontrolled activity in the brain that usually only lasts for a short period. While a seizure disorder is a medical condition, in which the person has episodes of uncontrolled activity in the brain producing symptoms that include one or more seizures. Epilepsy is considered a seizure disorder.
There are two types of major seizures, generalized and partial seizure type and the symptoms depend upon the part of the brain affected, and may include:- Loss of consciousness
- Thought disturbances
- Convulsions
- Eye rolling
- Stiff limbs
- Twitching on only one side or a portion of the body like an arm or leg.
- Involuntary urination or bowel movement
- Repetitive shaking or jerking of the body
- Staring into space, sometimes with eye blinking
- No loss of consciousness, but the person becomes confused for a few minutes
A third type of seizure is called unclassified seizure.
Seizure disorders are classified under two types of major seizures (generalized and partial), and a third type called unclassified seizures. There are about 40 types of named seizure disorders. The symptoms and signs are different depending on the part of the brain affected by the seizure. Examples of seizure disorders are:- Febrile seizures
- Benign Rolandic epilepsy
- Catamenial epilepsy
- Absence seizures
- Frontal lobe epilepsy
- Epilepsy
Sometimes there is a known cause for a seizure like alcohol, cocaine or other illegal drug abuse, drug reactions, a severe chemical imbalance in the blood, or medical problems like low blood pressure. Treatment, management, and prevention of seizures include medication and avoiding any known causes or common triggers.
REFERENCES:
CDC. "Types of Seizures." Updated: Apr 10, 2017.
Harvard Health Publications; Harvard Medical School. "Generalized Seizures (Grand Mal Seizures)."
Stress
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Stress Management Techniques
Stress may be considered as any physical, chemical, or emotional factor that causes bodily or mental unrest and that may be a factor in disease causation. An important goal for those under stress is the management of stress in our lives. Elimination of stress is unrealistic, since stress is a part of normal life. We can however, learn to manage stress through techniques such as exercise, relaxation, meditation, time management, and support systems so that we have control over our stress and its effects on our physical and mental health.sumatriptan
Sumatriptan (Imitrex, Alsuma, Imitrex STATdose System, Sumavel DosePro) is in a class of drugs referred to as selective serotonin receptor agonists, and is prescribed for the treatment of migraine and cluster headaches. Side effects, warnings and precautions, and drug interaction information should be reviewed prior to taking this medication.valproic acid
Valproic acid, divalproex (Depakote, Depakote ER, Depakene, Depakote Sprinkle, Depacon, Stavzor) is a medication prescribed for the treatment of seizures, bipolar disorder, and prevention of migraine headaches. Side effects, drug interactions, warnings and precautions, pregnancy information, and patient information should be reviewed prior to taking any drug.
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