Tuesday, February 27, 2007 Abdominal migraine, epilepsy
Abdominal Migraine
MIGRAINE headaches have been known to many, however only a few know about abdominal migraine.
Surveys conducted among children showed that 10 percent of those with migraine headaches also have abdominal migraine. Likewise, children with abdominal migraine are twice likely to have migraine headaches and more than twice as likely to have mothers with history of migraine headaches.
Abdominal migraine may affect 1-2 percent of children between the ages of 3 to 10 years of age. These are more common in girls than in boys.
Abdominal migraine is defined as recurrent identical episodes of intense abdominal pain often associated with migraine-like symptoms such as headaches, nausea (a feeling that one is about to vomit), vomiting, photophobia (abnormal intolerance to light), pallor, perspiration, slowing of pulse rate, diarrhea, and leg pains.
Abdominal pain can be located anywhere in the abdomen although more in the upper mid-abdomen. It often lasts from 2 hours to several days with a symptom free interval lasting several weeks to several months.
Repetition of identical attacks occurs anywhere from one per week to several times a year.
The cause of abdominal migraine is unknown. There is no specific diagnostic test for this problem. Caregivers' diagnosis is based on the typical presentation and family history of the patient. Other conditions should be considered to ensure that no other serious disease exists.
Treatment of abdominal migraine is the same with migraine headaches.
Medications must be given daily to prevent future attacks. Side effects from the use of medication may outweigh the benefit of treatment. The child must be allowed to do whatever he wants that will make him comfortable. Pain relievers help.
The decision to excuse the child from school will depend upon several factors among which are the age of the child, the duration, frequency, severity of pain and associated symptoms including the ability of the child to cope with the problem. Though some children will grow up with the typical adult migraine headaches, most children will outgrow abdominal migraine.
Abdominal Epilepsy
Epilepsy (convulsion, convulsive seizures) may be known to many of us but rarely or never have we heard of abdominal epilepsy.
Abdominal epilepsy is a controversial topic because it is not accepted by many.
Abdominal pain is a common warning signal of an impending epileptic attack. Sometimes abdominal pain is the only presenting symptom of an epileptic attack.
The pain is in upper mid abdomen, intense, abrupt in onset, and usually lasts for a few minutes. This may however recur several times a day for a period of several days.
In abdominal epilepsy, there is a state of altered consciousness (disorientation or confusion) during attacks usually ending in a deep sleep. Upon waking up, the child usually returns to normal.
Abdominal epilepsy is often confused with abdominal migraine. In children, it may be initially difficult to decide whether the symptoms of abdominal pain are epileptic or migrainous especially if the abdominal migraine is associated with convulsion and loss of consciousness.
Concurrence of migraine and epilepsy in one patient do happen. Eleven percent of epileptics also have migraine while 6.5 percent of patients with migraine have epilepsy. Although electro-encephalogram (EEG) or brain wave changes are seen in these children, very few will develop epileptic attacks.
The child with abdominal epilepsy with EEG (brain waves) abnormalities may be relieved by "Dilantin," a drug used for epileptic seizures. (PVI)
