Abdominal migraine

Question 1

What is abdominal migraine?

Answer 1

often associated with abdominal pain in addition to headaches; tends to occur in children. in some children, the abdominal pain predominates

Question 2

What are attacks of abdominal migraine like in children?

Answer 2

midline abdominal pain, associated with vomiting and facial pallor

Question 3

What usually exists in the family history of a child with abdominal migraine?

Answer 3

usually personal or family history of migraine

Question 4

What is the timing of abdominal migraine typically like?

Answer 4

long periods (often weeks) of no symptoms and then a shorter period (12-48 hours) of non-specific abdominal pain and pallor, with or without vomiting

Question 5

What treatment of abdominal migraine may be indicated?

Answer 5

treatment with anti-migraine medication, if problem causes school absences

Question 6

What are 3 types of medication that can be given for acute migraine in children, and therefore also for abdominal migraine?

Answer 6

1. paracetamol + NSAIDs (ibuprofen thought to be best)
2. triptans e.g. nasal sumatriptan
3. antiemetics for nausea e.g. prochlorperazine, cyclizine

Question 7

What are the side effects of triptans?

Answer 7

tingling, heat and heaviness/ pressure sensations

Question 8

What are the 2 best first-line preventatives for migraine in children according to GOSH (Great Ormond Street Hospital)?

Answer 8

Propranolol + pizotifen