Adult abdominal migraine: a case report and review of the literature / 中华神经科杂志

ABSTRACT

Objective:To analyze the clinical characteristics of adult abdominal migraine (AM), and improve the understanding and the accuracy of diagnosis of this disease.Methods:A case of adult AM diagnosed in the First Affiliated Hospital of Zhengzhou University in October 2019 was reported, and patients diagnosed with AM in the medical literature from January 2004 to May 2020 were searched and summarized.Results:A total of 634 articles were retrieved, among which 14 articles reported 17 adult AM patients,totally 18 adult AM patients (11 females),including the case diagnosed in the First Affiliated Hospital of Zhengzhou University. Only two cases were diagnosed within one year after the onset, and the other cases were diagnosed several years later, of which the longest diagnostic delay was 37 years. The location and nature of abdominal pain were diverse. The median frequency of episodes was 2.5 times per month. Sixteen patients had a duration of 2-72 hours per attack, and the longest one lasted for four days. Fourteen patients had nausea, 13 had vomiting, and seven had headache. Fifteen patients had a personal or family history of migraine. Sixteen patients′ episodes were separated by weeks to months. Because nonsteroidal anti-inflammatory drugs were not beneficial to adults with AM, abortive triptan therapy was recommended and anesthetics were considered when necessary. All patients responded to prophylactic migraine therapies.Conclusions:Adult AM is a rare disease. Patients with unexplained, recurrent and moderate to severe abdominal pain, combined with headache, a personal or family history of migraine, are highly suspected of having AM. Early diagnosis and prophylactic migraine therapies could contribute to good prognosis.