Abdominal migraine usually occurs in pediatric patients.
Criteria for diagnosis:
(1) >= 5 episodes that fulfill the clinical features (see below)
(2) exclusion of other diagnoses
Clinical features - all of the following:
(1) attacks of abdominal pain lasting from 1 to 72 hours
(2) presence of 2 or more of the following: nausea, vomiting, anorexia, pallor
(3) intensity moderate to severe
(4) location 1 of the following: midline, periumbilical, difficult to localize
(5) dull pain of "just sore" quality
where:
• Headache is not a criteria but may be present.
• Some patients develop migraine as adults.
• Some patients with cyclic vomiting may have abdominal migraine.
• Relief of symptoms with migraine therapy may support the diagnosis.
• Some patients may develop flushing during episodes.
• Some children develop dark shadows under their eyes
