OVERVIEW
Abdominal migraine syndrome is a rare type of migraine.
Abdominal migraine syndrome is a rare type of migraine, patients may have migraine manifestations, but mostly abdominal symptoms, abdominal pain and migraine may occur simultaneously or alternately, or abdominal pain without migraine. Clinical manifestations often include abdominal pain, migraine, accompanied by fever, chills, nausea, vomiting, diarrhea, etc., excessive sweating, pale or dark red skin, and fatigue. Triptans and ergot alkaloids can be used for treatment, and the prognosis is generally good.
Whether medical insurance
Yes
Department
Neurology, Gastroenterology
Clinical symptoms
Abdominal pain, migraine, fever, nausea, vomiting, diarrhea, etc.
Harm
Abdominal pain, diarrhea, migraine and other symptoms can affect the quality of life.
Complications
Arteriovenous malformation, neuropsychiatric dysfunction
Examination
Urine 5-hydroxytryptamine measurement, cerebrospinal fluid examination, ultrasonography, CT, platelet aggregation, etc.
Diagnosis
Diagnosis is made based on migraine, abdominal pain, etc. in conjunction with diagnostic criteria, and organic lesions are excluded by imaging tests, etc.
Treatment principle
Avoid triggers, treat with specific drugs such as ergot alkaloids, and combine with analgesics and other drugs for symptomatic treatment.
Curability
Treatment can relieve symptoms.
Dietary advice
Avoid diet containing tyrosine, caffeine, alcohol.
Etiology
Etiology
Unknown etiology, some family history, possibly vascular and neurologic dysfunction related.
Symptoms and Diagnosis
Typical Symptoms
The clinical picture is characterized by episodes of abdominal pain that last from a few minutes to several days. Abdominal pain and migraine may occur simultaneously or alternately, or abdominal pain may occur without migraine. The onset may be accompanied by fever, chills, nausea, vomiting, diarrhea, etc. The patient sweats profusely, has pale or dark red skin, and feels tired at the same time. There are no abnormal manifestations during the intervals. It is easy to be misdiagnosed as gastroenteritis, pancreatitis, appendicitis, etc., but there is no organic lesion in the abdomen after examination.
Diagnostic basis
1. Patients with migraine and abdominal pain should be diagnosed according to the diagnostic criteria for migraine, taking into account the frequency, duration, characteristics and accompanying symptoms of the attacks.
2. Laboratory examination
(1) Urine 5-hydroxytryptamine measurement: urine 5-hydroxytryptamine may be increased during migraine attacks.
(2) Cerebrospinal fluid examination: including red blood cell count, white blood cell count, intracranial pressure, etc., which can be used for headache caused by subarachnoid hemorrhage, intracranial infection, tumor, and abnormal intracranial pressure.
3.Imaging examination
(1) Ultrasonography: mainly through transcranial Doppler ultrasound migraine headache attack blood flow changes.
(2) CT: It can be used to detect tumors and other diseases. Angiography by injecting contrast agent can also be used to understand the cerebrovascular condition and detect vascular malformations.
Treatment
Treatment guidelines
Treatment with specific drugs such as ergot alkaloids, combined with symptomatic treatment with analgesics and other drugs.
Drug therapy
1. Specific drug therapy
Triptans are 5-hydroxytryptamine agonists, which can specifically control migraine attacks; ergot alkaloids are mostly used in the treatment of patients with severe attacks, but attention should be paid to their contraindications.
2.Symptomatic treatment
(1) Barbiturates and benzodiazepines can make patients go to sleep.
(2) Analgesics can be selected according to the patient’s pain level, such as nonsteroidal anti-inflammatory drugs and opioid analgesics.
Prognosis
The general prognosis is good.
Nursing care
Daily care
1. Pay attention to the combination of work and rest, ensure sleep time and sleep quality.
Keep the living environment quiet and comfortable, avoid noisy environment, and rest quietly in a room with low light.
Maintain a relaxed mood, reduce emotional tension and other psychological stress.
Appropriate exercises that emphasize breathing training and regulating breathing can be carried out.
Diet
Avoid tyrosine-containing, caffeine, alcohol, cold and smoked diets, such as cheese, chocolate, red wine and so on.