Abdominal Migraine

None — Abdominal Migraines

A traditional migraine is characterized by a severe, throbbing headache (often on one side of the head), nausea, and sensitivity to light and sound. Abdominal migraine is an unusual variant of migraine that is sometimes referred to as cyclic vomiting syndrome.

Instead of a severe headache, abdominal migraine is characterized by episodes of moderate to severe abdominal pain, nausea and vomiting. The symptoms can last from several hours to days and recur up to 12 times a year. The vomiting and pain are significant enough to cause loss of school or work. Richard Boles, M.D., Geneticist Physician with Children's Hospital Los Angeles, says patients often want to curl up in a ball and shut out the world. He says this is called a "conscious coma." With continued vomiting, patients can become dehydrated and require intravenous fluids.

About one-third of those with abdominal migraines have warning signs, similar to an "aura" before a regular migraine headache. Some of these symptoms include change in mood, stomach pain or upset, nausea, fatigue, anxiety, headache, and dizziness.

Researchers estimate about two percent of people in the U.S. have abdominal migraines. The condition is more common in children than in adults. Although the cause isn't clear, stress appears to play a big role in triggering the symptoms. Investigators report excessive emotional stress and extreme excitement (like an impending vacation) are two of the most common triggers. Upper respiratory infection, physical exhaustion, motion sickness, menstruation, overeating and certain foods can also trigger an episode in susceptible patients. Children with abdominal migraine appear to have a higher risk for developing traditional migraines later in life.

Diagnosis and Treatment

Boles says getting the right diagnosis for abdominal migraine can be tricky. Since the symptoms are mostly stomach-related, patients may be sent to a gastroenterologist for evaluation. However, testing won't find any abnormalities in the digestive system. That's because the real problem comes from the brain, specifically the autonomic nerves, which provide sensory control to the stomach. Researchers estimate it takes about 2.5 years to get an accurate diagnosis of abdominal migraine for children, and 3 to 8 years for adults.

Boles and his colleagues found that patients with abdominal migraines tend to inherit the symptoms from the maternal side of the family. Further investigation suggests the condition may be caused by a problem with mitochondrial DNA (which is only inherited from the mother). Mitochondria are the power production units in a cell, making all the energy a cell needs to remain vital and perform its function. In people with abdominal migraine, the mitochondria appear to produce less energy.

To combat the problem of energy production, Boles recommends an over-the-counter supplement, called co-enzyme Q10. He also recommends a migraine medication, amitriptyline. In his experience, 90 percent of patients have a significant reduction of their symptoms when taking a combination of the two treatments.

For general information on abdominal migraines or other types of headache:

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