Abdominal migraine (AM) is a functional disorder that usually manifests in childhood and adolescence, without a clear pathologic mechanism or biochemical irregularity.
Children frequently experience sporadic episodes of excruciating central abdominal pain accompanied by migrainous symptoms like nausea, vomiting, severe headaches, and general pallor.
[8] Abdominal migraine has been linked to specific alterations in the gut-brain axis, vascular dysregulation, modifications in the central nervous system, and genetic factors.
[5][8] A significant hereditary component may be involved in abdominal and other migraines due to their strong familial incidence,[11] especially in the case of mutations affecting cell membrane transport (channelopathies).
[12][13] While the pathophysiology of functional gastrointestinal disorders (FGIDs) has many potential contributors, the etiology of abdominal migraine is still unknown.
[14] It is thought that abnormal electrical discharge from the hypothalamus that travels to the cortex and autonomic nervous system[15] or variations in the cerebral artery's blood flow velocity cause attacks.
[17] Many episodic functional gastrointestinal disorders in childhood have been linked to mitochondrial disease,[18] hypothalamic-pituitary-axis dysfunction, and gene mutations; these associations have not, however, been studied in patients diagnosed with abdominal migraine.
[19] It's critical to rule out organic diseases as the source of a child's symptoms while also taking the patient's functional state into account.
When diagnosing abdominal migraine, a patient's complete medical history and physical examination are crucial.
The presence of visible or occult blood in the stool, dysphagia, hematemesis, bilious vomiting, fever, changes in growth pattern, and weight loss are a few examples of alarm symptoms.
[21] The Rome IV criteria state that paroxysmal bouts of intense, acute periumbilical, midline, or diffuse abdominal pain lasting at least an hour, exhibiting a recurrent pattern, being incapacitating, and interfering with regular activities can be used to diagnose abdominal migraine if at least two of these episodes take place over a six-month period.
A minimum of two out of three of the following criteria must also be met by the pain: dull or "just sore" quality; midline location, periumbilical, or poorly localized; and moderate to severe intensity.
It stands for stress management, travel advice, rest, emergency symptoms, sparkling lights, and snacks to avoid.
[26] Certain triggers, like bright light, restless nights, travel, and extended fasting, should probably be minimized or avoided once they have been identified.
[34] According to a case series, intravenous dihydroergotamine treatment prevented abdominal migraine attacks in five out of six pediatric patients.