Abdominal Migraines
Around 4% of children aged between 5 and 15 suffer from recurrent
abdominal pain. In children migraine can have a prevalence of abdominal
pain, and recurrence is 20 to 25% these abdominal pains decline
dramatically in adulthood and abdominal pain drops down to 1.5% in
adulthood.
It is recurrent abdominal pain, recurring (it takes at least five
occurrences before the diagnosis) The pain can be so intense as that
daily activity is hampered, it can last well over an hour and are
accompanied by at least two of the four following symptoms: loss of
appetite, nausea, vomiting, loss of facial color.
There may be a family history of migraine or the subsequent emergence of
a migraine characteristic, defined according to medical criteria. These
criteria may have the following clinical features. The pain is often
localized loosely, usually in the middle part of the stomach, often
around the navel; on the contrary, abdominal pain could also be a sign
of an organic lesion (appendicitis, colitis,).
The pain often begins in the morning and does not allow normal activity,
the children generally want to lie down and sleep. The maximum pain
period is between 10 and 15 years old. The duration exceeds one hour but
is on average 24 hours.
Several experts pointed out that the abdominal migraine as defined
migraine has the same characteristics evolving, in both cases; we are
facing recurrent episodes of moderate to severe pain that lasts often
half a day to a day. Abdominal migraine evolves into a migraine in 90%
of sufferers.
Any child with recurrent abdominal pain should be treated in generally
specialized care. Among the anomalies to look for are recurring kidney
infections, hydronéphroses, ulcers, pancreatitis, gastro-esophageal
reflux, Crohn's disease, sorbitol malabsorptions or lactose intolerance.
As in a migraine (headache), we must try to control and trigger factors
such as fasting, the lack off or delay in meals, dietary factors to be
specified depending on the questioning of each patient. The regulation
of sleep is important to maintain and control emotional factors. Some
studies have shown still limited the usefulness of using a prophylactic
treatment in severe cases including propanolol (Indéral ),
ciproheptadine (Periactin ), pizotifen (Sandomigran ).
A Vomiting pattern is also part of the precursors of a migraine.
Epidemiologists who studied abdominal migraines believe the prevalence
of these cyclical vomiting events was 2% among children 5 to 15 years
old. The symptoms start earlier than abdominal pain, between 6 months
and up to19 years old, mostly between 2 and 6 years and can take 10
years to disappear.
A family history of migraine is registered in approximately 70 to 80% of
cases.
The diagnostic criteria are as follows. Severe cyclical vomiting or
recurrent vomiting. Each episode lasts a few hours to several days (on
average 24 hours).
The symptoms disappear completely between each occurrence. As well as
vomiting there may be drowsiness, lethargy, or sometimes even stupor, in
90% of cases, nausea in 70% of cases, loss of appetite in 75% of cases,
abdominal pain in 80% of cases.
Here are some other characteristics of this affection. The episodes of
vomiting often begin in late night, are severe, frequent (there are more
than 4 vomiting episodes per hour) and could lead to dehydration as this
is often bilious vomiting. The frequency of episodes is about 6 to 12
per year. These episodes of vomiting often seem triggered by an
infection (40%), stress, dietary factors.
During the period of vomiting in 40% of cases often had photophobia.
During these episodes, there are behavioural changes with irritability,
inward-looking, sometimes aggressiveness. |
