Sangermani R, Pirovano S, Vaccari R, Gibelli M, Rossi A
Divisione di Pediatria, Ospedale S. Carlo Borromeo, Milano, Italia.
Pediatr Med Chir. 1992 Mar-Apr;14(2):163-5.
Migraine is a variant of headache often associated with neurologic and/or vegetative symptoms mainly represented by abdominal pain. This symptom may occur some hours before migraine manifestation and in these cases the differential diagnosis with other clinical conditions characterized by abdominal pain, which is very common during childhood, may be difficult. Abdominal migraine can be diagnosed only if a close relationship is demonstrated between the abdominal symptoms and migraine. Alteration of consciousness is a well known feature during migraine and in some cases EEG may show SNC involvement during the attack. We report a case of abdominal migraine attack evaluated by EEG. The patient, a 10 years old male, presented with a picture of acute abdomen. An EEG performed at the occurrence of the early headache symptoms and of consciousness alteration demonstrated a pattern characterized by a lowering in the electric activity on the left hemisphere. Some hours later he developed a clear migraine followed by disappearance of the abdominal symptoms. This observation confirms the possible association of migraine with a picture simulating an acute abdomen and suggests that the differential diagnosis with a true surgical condition may be achieved by the observation of the progression of symptoms and by early evaluation of patient with EEG.
偏头痛是头痛的一种变体，常伴有主要以腹痛为表现的神经和/或植物神经症状。这种症状可能在偏头痛发作前数小时出现，在这些情况下，与儿童期非常常见的以腹痛为特征的其他临床病症进行鉴别诊断可能会很困难。只有当腹部症状与偏头痛之间存在密切关系时，才能诊断为腹型偏头痛。意识改变是偏头痛期间众所周知的特征，在某些情况下，脑电图（EEG）可能显示发作期间有中枢神经系统（SNC）受累。我们报告一例通过脑电图评估的腹型偏头痛发作病例。该患者为一名10岁男性，表现为急腹症。在早期头痛症状和意识改变出现时进行的脑电图显示出一种模式，其特征是左半球电活动降低。数小时后，他出现了典型的偏头痛，随后腹部症状消失。这一观察结果证实了偏头痛可能与模拟急腹症的症状相关，并表明通过观察症状进展和对患者进行早期脑电图评估，可以与真正的外科病症进行鉴别诊断。
