Azmy Demiana J, Qualia Cary M
Albany Medical College, Albany, New York.
Division of Pediatric Gastroenterology, Bernard and Millie Duker Children's Hospital, Albany Medical Center, Albany, New York.
Gastroenterol Hepatol (N Y). 2020 Dec;16(12):632-639.
Abdominal migraine is a type of functional abdominal pain disorder that affects 0.2% to 4.1% of children. It consists of paroxysmal, recurrent, and acute abdominal pain attacks with associated symptoms, including pallor, nausea, vomiting, anorexia, headache, and photophobia. In between episodes, patients return to their baseline health. Abdominal migraine is a clinical diagnosis. Its diagnostic criteria are outlined under the Rome IV criteria and the International Classification of Headache Disorders III criteria. Hypothesized contributors to its pathophysiology include a combination of visceral hypersensitivity, gut-brain enteric nervous system alterations, and psychological factors. Treatment is focused on preventive measures and mostly includes nonpharmacologic approaches. Possible pharmacologic treatments include abortive medications used for migraine headaches such as analgesics and antiemetics. Abdominal migraine is likely underdiagnosed and is poorly understood. Individuals who have abdominal migraine report a lower quality of life, rendering it an important diagnosis. The aim of this article is to review the epidemiology, clinical presentation, pathophysiology, diagnosis, and treatment of abdominal migraine in children.
腹型偏头痛是一种功能性腹痛障碍,影响0.2%至4.1%的儿童。它由阵发性、复发性和急性腹痛发作以及相关症状组成,包括面色苍白、恶心、呕吐、厌食、头痛和畏光。在发作间期,患者恢复到基线健康状态。腹型偏头痛是一种临床诊断。其诊断标准在罗马IV标准和《国际头痛疾病分类》第三版标准中有概述。其病理生理学的假定因素包括内脏超敏反应、肠脑肠神经系统改变和心理因素的综合作用。治疗重点在于预防措施,主要包括非药物方法。可能的药物治疗包括用于偏头痛的终止发作药物,如镇痛药和止吐药。腹型偏头痛可能未得到充分诊断且了解不足。患有腹型偏头痛的个体报告生活质量较低,使其成为一个重要的诊断。本文的目的是综述儿童腹型偏头痛的流行病学、临床表现、病理生理学、诊断和治疗。