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Recurrent Gastrointestinal Disturbance: Abdominal Migraine and Cyclic Vomiting Syndrome

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Abstract

Primary headache disorders, including migraine, are some of the most common neurological disorders presenting to hospital. Episodic syndromes that may be associated with migraine, including recurrent gastrointestinal disturbances such as abdominal migraine and cyclic vomiting, often pre-date or co-occur with the onset of migraine in a child who is at risk of developing the headache condition. The purpose of this review is to evaluate the two most common episodic syndromes, abdominal migraine and cyclic vomiting syndrome, including their pathophysiology, common presentations, and diagnostic criteria. Differential diagnosis and “red flag” features are outlined, and an approach to diagnostic work-up is offered. Finally, we provide an evidence-based review of management options and long-term prognosis. Future research should include randomized trials for the acute and preventive treatment of these disorders, as well as research as to whether early intervention can prevent progression to migraine and/or mitigate migraine severity.

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Authors and Affiliations

  1. Department of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada

    Samantha Irwin

  2. Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada

    Rebecca Barmherzig

  3. Department of Neurology, University of California, UCSF Benioff Children’s Hospital, San Francisco, CA, USA

    Amy Gelfand

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  1. Samantha Irwin
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Correspondence to Samantha Irwin.

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Rebecca Barmherzig declares no conflict of interest.

Samantha Irwin has a patent entitled HeadSoothe which is working to develop a combination nutraceutical for headache. This patent is pending.

Amy Gelfand reports consulting fees from Eli Lilly, Zosano and eNeura, paid travel funds from Teva, and research funds from eNeura and Allergan.

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Irwin, S., Barmherzig, R. & Gelfand, A. Recurrent Gastrointestinal Disturbance: Abdominal Migraine and Cyclic Vomiting Syndrome. Curr Neurol Neurosci Rep 17, 21 (2017). https://doi.org/10.1007/s11910-017-0731-4

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