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[Abdominal migraine simulating acute abdomen]
R Sangermani1, S Pirovano, R Vaccari
1Divisione di Pediatria, Ospedale S. Carlo Borromeo, Milano, Italia.
Summary
Abdominal migraine in children can mimic acute abdomen, complicating diagnosis. Electroencephalography (EEG) may aid in differentiating it from surgical emergencies by detecting central nervous system (CNS) involvement during early symptoms.
Area of Science:
- Neurology
- Pediatrics
- Gastroenterology
Background:
- Abdominal migraine is a common pediatric condition presenting with abdominal pain, often preceding or accompanying neurological symptoms like headache.
- Differentiating abdominal migraine from acute surgical abdominal conditions in children can be challenging due to overlapping symptoms.
- Central nervous system (CNS) involvement, including altered consciousness, is a recognized feature of migraine.
Observation:
- A 10-year-old male presented with symptoms suggestive of acute abdomen.
- An electroencephalogram (EEG) performed during early headache and altered consciousness revealed reduced electrical activity in the left hemisphere.
- The patient subsequently developed clear migraine symptoms, with resolution of abdominal pain.
Findings:
- The case highlights the association between abdominal migraine and symptoms mimicking acute abdomen.
- EEG demonstrated CNS changes correlating with the early stages of the migraine attack.
- The progression of symptoms, from abdominal pain to neurological manifestations, was key to diagnosis.
Implications:
- This case suggests EEG can be a valuable tool in the differential diagnosis of pediatric abdominal pain, particularly when migraine is suspected.
- Early EEG evaluation may help distinguish abdominal migraine from true surgical emergencies.
- Understanding the neurological underpinnings of abdominal migraine can improve diagnostic accuracy and patient management.