Abdominal migraine in a pediatric patient

Abstract

Abdominal migraine (AM) is a syndrome usually diagnosed in childhood. The AM syndrome comprises episodic attacks of severe, recurrent, and chronic abdominal pain localized in the periumbilical area, followed by symptoms like headache, anorexia, nausea, vomiting, or pallor. Between the abdominal migraine episodes the child felt good and continued to develop well. The pathophysiological process is presumed to be similar to that of other functional gastrointestinal disorders (FGIDs) and cephalic migraine. It is vital to assess anamnesis, dietary and social history, detailed physical examination, and symptom-based guidelines. Evaluation of the patient for the presence of any potential alarming symptoms or signs, to exclude an organic disease, is essential. The major problem is the lack of knowledge regarding its unclear pathophysiology. Nonpharmacological and pharmacological treatment alternatives vary. Although thorough diagnostic criteria under Rome IV classification of FGIDs and International Classification of Headache Disorders are available, AM persists to be an underdiagnosed entity. A definite diagnosis of abdominal migraine allows appropriate management and avoids unnecessary investigations and incorrect treatments.