Abdominal Migraine

Abdominal migraine is a form of migraine that is most often seen in children, usually under the age of 12.

Why do we call this abdominal migraine? Well, children can have the pain in the stomach that comes and goes and lasts from 1-72 hours.

Something to keep in mind with headache syndromes in children :they usually are much shorter, say 2-4 hours, than adult headaches.

Abdominal migraine is a migraine varient (has different symptoms) in that the headache may or may not appear.

The pain is usually dull, can occur anywhere in the abdomen and can range from moderate to severe.

Nausea and vomiting are usually present, as is fatigue and drowsiness. These children may grow up to have migraines (both with and without aura) as adults and usually there is a strong family history of headaches.

If the medical work up for GI problems is negative, and the family history shows headaches, then abdominal migraine should be considered. The diagnosis can be made after 5 attacks have occurred.

There is a strong genetic component with migraines, so if someone else in your family has migraines, this is a clue as to what type of headache your child is getting.

At the age of 12, the incidence of headaches in girls and boys is about 1:1. By the time they are 21, most boys grow out of their headaches and the incidence of migraines in children changes to 3:1, girls over boys!

This is due to the hormone component that girls have to deal with! This leads me to..

Adolescent Migraine

As mentioned, by the time migraineurs reach adolescence, the boys begin to grow out of their migraines, while the girls may start or get a bit worse.

Something we have noticed in our clinic is that teenagers respond faster to lifestyle changes.

If you have a teen migraineur in your house, challange them to take charge of their own headaches. Information from the net rules with this group! They may find some great information here, or at KidsHealth.org

One of the questions many parents ask is "When should I take my child to the doctor?" Well if you have migraines, then you might want to make an appointment now. The genetic factor can't be overlooked so chances are the diagnosis is migraine for the child.

Things to be concerned about with kids headaches (get to the doctor now!)

Headaches start under the age of 7

A change in the headaches

Blackouts or seizure with headaches

Personality changes

School failure

Balance or coordination problems

Failure to grow or develop properly

Headache with fever and vomiting

Have your teen keep a diary of headaches to track their triggers. Have you noticed many teens rush out the door without eating. Sometimes it is the middle of the afternoon before they get lunch break. That long of a period of time, from the night before, means low blood sugar and THAT means headache!

Here is an excellent article on migraine in teenagers.

Treatment of Abdominal Migraine

Treatment of abdominal migraine varies from patient to patient depending on the main symptoms. If a child is young, then management may include anti-inflammatories such as Aleve or perhaps Tylenol.

Midrin might be a good option for an older child and anti-nausea agents will calm the nausea and vomiting.

Generally, triptans are not used in this population as triptans do not work too well for abdominal pain. They are best left for the typical migraine pain of the head.

Most children grow out of abdominal migraine, but rarely some do carry the diagnosis for several years. Also rarely, this form of atypical migraine may be seen in adults.

TREATMENT OF REGULAR MIGRAINES If your child is of adult weight and height, they probably should be seen in an adult headache clinic for specialized treatment. The majority of my adolescent migraineurs are on the same medications we give to adults and are doing very well.

Younger patients (under 12) should be treated by a pediatric neurologist.

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