Abdominal Migraine

Sonal Bhatia
Abdominal Migraine - Introduction
Abdominal migraine (AM) is an under-diagnosed cause of recurrent abdominal pain in the pediatric population.
The term AM was used by Brams, close to a century ago, to describe periodic attacks of epigastralgia with symptom-free intervals between the episodes and a history of migraine in either the patient or his relative [1]. Since then, more precise criteria have been proposed to aid in the diagnosis of AM.
In 2003, AM was identified as one of the “childhood periodic syndromes that are commonly precursors of migraine” in the International Classification of Headache Disorders (ICHD-2) published by the International Headache Society (IHS); this was further corroborated by ICHD-3 laid out in 2013. In 2006, Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders separately proposed identifying markers for AM which succeeded the 1999 Rome II Gastroenterology Criteria.
In a series of patients from a pediatric gastrointestinal clinic, at least 4-15 % of children with chronic, recurrent, idiopathic abdominal pain met diagnostic criteria for AM [2]. A UK study demonstrated a slightly lower prevalence at 2.4 % [3].
Interestingly, the application of Rome III criteria for AM classified a greater percentage of children as meeting the diagnostic criteria for AM when compared to the use of Rome II criteria (23.1 % vs 5.7%) [4].
The exact pathophysiology of AM is not clearly understood. There is overlap between AM and migraine as there is between the various functional gastrointestinal disorders such as cyclic vomiting and irritable bowel syndrome.

Abdominal Migraine Abdominal Migraine 02/13/2016
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