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[Abdominal migraine in adults]

M Pryszmont1

  • 1Katedry i Kliniki Neurologicznej AM, Białymstoku.

Neurologia I Neurochirurgia Polska
|October 7, 1998
PubMed
Summary

This case study highlights a 35-year-old woman experiencing severe nocturnal abdominal pain, nausea, and fainting, diagnosed as abdominal migraine. Treatment with Pizotifen and later Nitrendipine proved effective in managing these debilitating episodes.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Clinical Case Study

Background:

  • Abdominal migraine is a functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain.
  • It often affects children but can persist into adulthood, presenting diagnostic challenges due to its varied symptomatology.
  • Family history of migraine is a significant risk factor, suggesting a potential genetic predisposition.

Observation:

  • A 35-year-old woman presented with a four-year history of severe, nocturnal abdominal pain, nausea, vomiting, diarrhea, and transient loss of consciousness.
  • Attacks occurred exclusively between 1-3 a.m., relieved by emesis and defecation, with post-attack weakness and numbness.
  • Extensive gastrological and neurological investigations, including EEG and cranial CT, were unremarkable, ruling out organic pathology and epilepsy.

Findings:

  • The patient's history of childhood paroxysmal abdominal pain and her mother's migraine supported a diagnosis of abdominal migraine.
  • Treatment with Pizotifen (1.5 mg/day) for three months completely resolved the nocturnal attacks.
  • Upon discontinuation, attacks recurred but were less severe; subsequent treatment with Nitrendipine (5 mg/night) ceased the episodes, though the patient preferred Pizotifen.

Implications:

  • This case underscores the importance of considering abdominal migraine in adults with recurrent, unexplained nocturnal abdominal pain, especially with a migraineous background.
  • Pharmacological management, including Pizotifen and potentially other migraine prophylactic agents, can be effective in controlling severe symptoms.
  • Further research into the pathophysiology and optimal treatment strategies for adult abdominal migraine is warranted.

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