Hi, this is Tom, and in this episode I'm going to be going through abdominal migraine,

and you can find notes at zero to finals.com and in the zero to finals pediatrics book,

and you can find flashcards and questions at members.0.0.0.0.com. And at the end of this episode, we'll go through

some questions so you can test yourself on what you just heard. So let's jump straight in.

Abdominal migraine is a cause of recurrent episodes of central abdominal pain. It tends to affect children, but it can also affect

adults. Abdominal migraine most often occurs in children aged 3 to 10 years and it's more

common in girls. Children with abdominal migraine are more likely to go on to develop traditional migraine headaches

when they get older as adolescents or adults. No underlying physical pathology will be present

on examination or investigations. The episodes may have triggers such as stress, lack of sleep,

dehydration, certain foods and bright lights. Let's go through the presentation.

Abdominal migraine presents with episodes of peri umbilical central abdominal pain lasting between one hour and three days.

There may be associated nausea and vomiting, anorexia or loss of appetite, pallor, where the skin goes pale, headache, photophobia or discomfort with

bright lights, and aura, for example, visual changes like sparks in the vision, or a tingling

sensation in the hands. Let's go through management.

Management of abdominal migraine is similar to traditional migraines.

Adequate explanation and education are essential.

Treating the acute attacks, when the abdominal pain occurs may involve a low stimulus environment,

for example going to a quiet dark room, paracetamol, ibuprofen, and sometimes triptans,

for example, sumatriptan.

Longer-term preventative medications to prevent the occurrence of the abdominal migraines

include pizotiphen, which is a serotonin antagonist, or propranolol, which is a non-selective beta blocker.

Pisotephen needs to be withdrawn slowly when stopping it, as it's associated with withdrawal

...