1
|
Kizhakkayil Tency N, Roy A, Krishnakumaran N, Thomas AM. Unraveling Abdominal Migraine in Adults: A Comprehensive Narrative Review. Cureus 2023; 15:e43760. [PMID: 37727183 PMCID: PMC10506737 DOI: 10.7759/cureus.43760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/21/2023] Open
Abstract
Abdominal migraine is a condition characterized by recurrent episodes of abdominal pain accompanied by migraine-associated symptoms, primarily affecting pediatric populations. Its occurrence in adults is often overlooked due to limited literature on adult abdominal migraine. This article provides an overview of the current understanding and management of abdominal migraine in adult populations, including the diagnostic criteria, pathophysiology, differentiating features of other associated gastrointestinal pain syndromes, and various treatment approaches based on available literature. The review acknowledges the limitations, including the scarcity of literature on adult abdominal migraine and the absence of a systematic approach. It emphasizes the need for further research to enhance our understanding of this condition and establish evidence-based treatment guidelines specifically for adults. Accurate diagnosis and patient education are crucial for physicians in recognizing abdominal migraine as a differential diagnosis in cases of long-standing recurrent abdominal pain, promoting the importance of further research to advance our knowledge and improve patient outcomes.
Collapse
Affiliation(s)
| | - Archa Roy
- Department of Internal Medicine, Government T D Medical College, Alappuzha, IND
| | | | - Anju Maria Thomas
- Department of Internal Medicine, Government T D Medical College, Alappuzha, IND
| |
Collapse
|
2
|
Cheema S, Matharu M. Abdominal migraine and cyclical vomiting syndrome. HANDBOOK OF CLINICAL NEUROLOGY 2023; 198:209-219. [PMID: 38043963 DOI: 10.1016/b978-0-12-823356-6.00006-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Abdominal migraine and cyclical vomiting syndrome (CVS) are characteristic syndromes which have overlapping characteristics with migraine but lack the cardinal symptom of headache. Both abdominal migraine and CVS are characterized by recurrent attacks of nausea, vomiting, and/or abdominal pain lasting hours to a few days, with symptom freedom between attacks. Both abdominal migraine and CVS typically occur in children and adolescents, who often go on to develop more typical migraine headaches when older, but may also present for the first time in adults. Due to their shared characteristics and association with migraine headaches, abdominal migraine and CVS are sometimes called "migraine equivalents," and their pathophysiology is assumed to overlap with migraine headache. This chapter describes what is known about the clinical characteristics, epidemiology, pathophysiology, and prognosis of abdominal migraine and CVS, and explores their relationship to migraine. We also review the existing evidence for the nonpharmacological management, acute treatment of attacks, and preventive treatments for both abdominal migraine and CVS.
Collapse
Affiliation(s)
- Sanjay Cheema
- Headache and Facial Pain Group, University College London (UCL) Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Manjit Matharu
- Headache and Facial Pain Group, University College London (UCL) Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
| |
Collapse
|
3
|
Redon S. Episodic syndromes that may be associated with migraine: What adult neurologists need to know. Rev Neurol (Paris) 2021; 177:773-778. [PMID: 34366172 DOI: 10.1016/j.neurol.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 11/24/2022]
Abstract
Four episodic syndromes are recognized in the current version of the International Classification of Headache Disorders (ICHD): cyclic vomiting syndrome (CVS); abdominal migraine; benign paroxysmal vertigo; benign paroxysmal torticollis. Previously called childhood periodic syndromes, they are thought to be early expressions of a migrainous spectrum. They usually occur in childhood or adolescence and some of these patients will develop migraine later in childhood or in adulthood. More rarely, some of these disorders, in particular CVS and abdominal migraine, can persist or even begin at adulthood. The concept of episodic syndromes associated with migraine in adults is relatively recent, recognized for the first time in the version III-beta of the ICHD (2013). It is important for the adult neurologist to recognize the clinical pattern of these disorders. Lack of knowledge of these disorders often leads to delayed diagnosis, and a large number of complementary tests. Treatments are often borrowed from migraine abortive and preventive treatments. This review summarizes the characteristics of episodic syndromes and is particularly focused on data in adults.
Collapse
Affiliation(s)
- S Redon
- Department of Evaluation and Treatment of Pain, FHU INOVPAIN, la Timone Hospital, AP-HM, Marseille, France.
| |
Collapse
|
4
|
Abstract
Migraine is a complex genetic brain disorder with an intricate pathogenesis and polymorphous clinical presentations, particularly in children. In this Perspective, we describe the different phenotypes of migraine in children, including conditions that have been referred to in the International Classification of Headache Disorders as "syndromes that may be related to migraine''. Evidence is presented for the integration of abdominal migraine, cyclical vomiting syndrome, benign paroxysmal vertigo, benign paroxysmal torticollis and infantile colic into the unified diagnosis of 'childhood migraine syndrome' on the basis of clinical and epidemiological characteristics, and shared inheritance. In our opinion, such integration will guide clinicians from specialities other than neurology to consider migraine in the assessment of children with these disorders, as well as stimulate research into the genetics, pathophysiology and clinical features of all disorders within the syndrome. A diagnosis of childhood migraine syndrome would also enable patients to benefit from inclusion in clinical trials of old and new migraine treatments, thus potentially increasing the number of treatment options available.
Collapse
|
5
|
Karmali R, Hall‐Wurst G. Fifty-eight-year-old female with abdominal migraine: A rare cause of episodic gastrointestinal disturbance in adults. Clin Case Rep 2020; 8:1340-1345. [PMID: 32884749 PMCID: PMC7455446 DOI: 10.1002/ccr3.2891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 12/17/2022] Open
Abstract
Abdominal migraine (AM) is a predominantly pediatric condition characterized by erratic episodes of abdominal pain, nausea, and vomiting with spontaneous periodic relief. It should be considered as a differential diagnosis in symptomatic adults.
Collapse
Affiliation(s)
- Rehan Karmali
- Orange Regional Medical Center ‐ Internal MedicineMiddletownNew York
- Touro College of Osteopathic MedicineMiddletownNew York
| | - Gordon Hall‐Wurst
- Orange Regional Medical Center ‐ Internal MedicineMiddletownNew York
| |
Collapse
|
6
|
Napthali K, Koloski N, Talley NJ. Abdominal migraine. Cephalalgia 2016; 36:980-6. [DOI: 10.1177/0333102415617748] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 10/25/2015] [Indexed: 12/31/2022]
Abstract
Background Abdominal migraine (AM) is a syndrome usually recognised in childhood. The syndrome is characterised by episodic attacks of severe abdominal pain and vasomotor symptoms, nausea and vomiting. It is a poorly understood disorder largely due to a limited recognition of this condition by the medical community. However, the publication of AM diagnostic guidelines by the International Headache Society a decade ago and the recognition of AM in the Rome Classification of functional gastrointestinal disorders have helped to legitimise this disorder and facilitate research. Overview AM is relatively common, affecting up to 4% of the paediatric population. Whilst AM is not believed to continue into adulthood for the majority of children, it has the propensity to develop into probable migraine and recurrent abdominal pain in adulthood. The pathophysiology of this condition remains unclear and as a result treatment for this condition is suboptimal with avoidance of triggers and prophylactic treatment currently recommended when an episode begins. Conclusion The recognition of AM by the IHS and the Rome Foundation should help facilitate future research into the pathophysiology of this debilitating condition and as a result better treatments for AM should emerge. Randomised controlled trials should be a priority.
Collapse
Affiliation(s)
- Kate Napthali
- Faculty of Health and Medicine, University of Newcastle, Australia
| | - Natasha Koloski
- Faculty of Health and Medicine, University of Newcastle, Australia
| | | |
Collapse
|
7
|
Abstract
Emergency department providers have become skilled at triaging patients with abdominal pain requiring surgical interventions. Abdominal pain mimics, medical conditions that cause the sensation of abdominal pain without abdominal abnormality, continue to puzzle the best physicians.
Collapse
Affiliation(s)
- Jessica Palmer
- Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving Street Northwest NA 11-77, Washington, DC 20010, USA
| | - Elizabeth Pontius
- Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving Street Northwest NA 11-77, Washington, DC 20010, USA; Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA.
| |
Collapse
|
8
|
Abstract
A 52-year-old woman presented with recurrent, severe abdominal pain. Laboratory tests and imaging were insignificant, and treatment for functional dyspepsia was ineffective. The poorly localized, dull, and severe abdominal pain, associated with anorexia, nausea, and vomiting, was consistent with abdominal migraine. The symptoms were relieved by loxoprofen and lomerizine, which are used in the treatment of migraine. We herein report a case of abdominal migraine in a middle-aged woman. Abdominal migraine should be considered as a cause of abdominal pain as it might easily be relieved by appropriate treatment.
Collapse
Affiliation(s)
- Yosuke Kunishi
- Department of Gastroenterology, Kanagawa Prefectural Ashigarakami Hospital, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Draeger-Muenke R. Functional Abdominal Pain: "Get" the Function, Loose the Pain. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2015; 58:34-62. [PMID: 26046716 DOI: 10.1080/00029157.2015.1031208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Functional abdominal pain is a mind-body, psychosocial, and self-reinforcing experience with significant consequences for the sufferer and the surrounding support network. The occurrence of unpredictable symptoms and their severity add an element of dread and feeling out-of-control to daily life and often reduce overall functioning in a downward spiral. Two clinical presentations of functional abdominal pain are offered in this article (composites to protect confidentiality) dealing with abdominal pain syndrome and abdominal migraines. The treatment demonstrates the use of hypnotic principles for self-regulation, exploration, and meaning-making. Hypnosis treatment is conducted in combination with mindfulness-based interventions and Traditional Chinese Medicine's (TCM) teachings regarding abdominal health and illness. The clinical examples illustrate medical findings that suggest children with early life stress and an early onset of gastrointestinal somatization may not simply outgrow their functional abdominal pain but may suffer into adulthood.
Collapse
|
10
|
Evans RW, Whyte C. Cyclic vomiting syndrome and abdominal migraine in adults and children. Headache 2014; 53:984-93. [PMID: 23721241 DOI: 10.1111/head.12124] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2013] [Indexed: 11/30/2022]
|
11
|
Kakisaka Y, Jin K, Kato K, Iwasaki M, Nakasato N. Temporal intermittent rhythmic delta activity and abdominal migraine. Neurol Sci 2014; 35:627-8. [PMID: 24384966 DOI: 10.1007/s10072-013-1625-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Yosuke Kakisaka
- Department of Epileptology, Tohoku University School of Medicine, Seiryo-machi 2, Aoba-ku, Sendai, 980-8575, Japan,
| | | | | | | | | |
Collapse
|
12
|
Dees B, Coleman-Jackson R, Hershey LA. Managing migraine and other headache syndromes in those over 50. Maturitas 2013; 76:243-6. [DOI: 10.1016/j.maturitas.2013.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/15/2013] [Indexed: 11/17/2022]
|
13
|
Zhao LJ, Yang YJ, Wu H, Huang SM, Liu K. Perivascular epithelioid cell tumor of the liver: a case report and literature review. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2013; 47:e27. [PMID: 23832736 DOI: 10.1345/aph.1r620] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Perivascular epithelioid cell tumors (PEComas) are mesenchymal tumors containing variable component of smooth muscles, fat and vessels. They occured pretty rare in the liver and no characteristic of imaging data have been demonstrated up to now. We herein present a case of a 58-year-old man with a hepatic PEComa which was correct diagnosed through immunohistochemical confirmation with HMB-45. The clinicopathological and imaging features of hepatic PEComa were analyzed retrospectively. This is the first paper which demonstrated the characteristic of imaging data among liver PEComas and other liver lesions. However, the diagnostic criteria of PEComa depends on pathology. Hepatectomy is the effective treatment.
Collapse
Affiliation(s)
- L-J Zhao
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | | | | | | | | |
Collapse
|
14
|
Landy SH, Kaniecki RG, Taylor FR. Abstracts and Citations. Headache 2013. [DOI: 10.1111/head.12119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
15
|
Roberts JE, deShazo RD. Abdominal migraine, another cause of abdominal pain in adults. Am J Med 2012; 125:1135-9. [PMID: 22939361 DOI: 10.1016/j.amjmed.2012.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 06/11/2012] [Accepted: 06/11/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Abdominal migraine is a diagnostically challenging childhood disorder, characterized by recurrent episodes of abdominal pain, which has not been clearly demonstrated to occur in adults. METHODS We used 2 sets of consensus criteria for the diagnosis of abdominal migraine in children to evaluate adults suspected of having this condition in both our own patient population and in the medical literature. Two patients in our clinic and 11 patients from the medical literature composed our initial study cohort and were analyzed using the International Classification of Headache Disorders, 2(nd) Edition and American College of Gastroenterology Rome III Diagnostic Criteria for abdominal migraine in children. RESULTS Ten of these patients met inclusion criteria for definite or probable abdominal migraine and comprised our final study cohort. The 10 patients from this adult cohort shared common demographic and clinical characteristics with children suffering from abdominal migraine, including a familial history of migraine in 90%. CONCLUSIONS Our findings demonstrate that abdominal migraine occurs and should be considered in the differential diagnosis of recurrent abdominal pain in adults, especially if there is a family history of migraine headaches.
Collapse
Affiliation(s)
- John E Roberts
- Departments of Medicine and Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | | |
Collapse
|
16
|
Sonal Sekhar M, Sasidharan S, Joseph S, Kumar A. Migraine management: How do the adult and paediatric migraines differ? Saudi Pharm J 2011; 20:1-7. [PMID: 23960771 DOI: 10.1016/j.jsps.2011.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Accepted: 07/08/2011] [Indexed: 10/17/2022] Open
Abstract
Migraine is one of the common causes of severe and recurring headache. It may be difficult to manage in primary care settings, where it is under diagnosed and medically treated. Migraine can occur in children as well as in adults and it is three times more common in women than in men. Migraine in children is different from adults in various ways. Migraine management depends on the various factors like duration and severity of pain, associated symptoms, degree of disability, and initial response to treatment. The therapy of children and adolescents with migraines includes treatment modalities for acute attacks, prophylactic medications when the attacks are frequent, and biobehavioural modes of treatment to aid long-term management of the disorder. The long lasting outcome of childhood headaches and progression into adult headaches remains largely unknown. However, it has been suggested that adult migraine may represent a progressive disorder. In children, the progressive nature is uncertain and further investigations into longitudinal outcome and phenotypic changes in childhood headaches have yet to be recognized. Even though paediatric and adult migraines seem to be slightly different from one another, but not enough to categorize either as sole.
Collapse
Affiliation(s)
- M Sonal Sekhar
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, Karnataka 576104, India
| | | | | | | |
Collapse
|
17
|
Cawello W, Braun M, Boekens H. Absorption, Disposition, Metabolic Fate, and Elimination of the Dopamine Agonist Rotigotine in Man: Administration by Intravenous Infusion or Transdermal Delivery. Drug Metab Dispos 2009; 37:2055-60. [DOI: 10.1124/dmd.109.027383] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
18
|
Newman LC, Newman EB. Rebound Abdominal Pain: Noncephalic Pain in Abdominal Migraine is Exacerbated by Medication Overuse. Headache 2008; 48:959-61. [DOI: 10.1111/j.1526-4610.2008.01126.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|