title: Recurrent Gastrointestinal Disturbance: Abdominal Migraine and Cyclic Vomiting Syndrome.
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.
authors.affiliation: Department of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. Samantha.Irwin@Sickkids.ca.
authors.forename: Samantha
authors.initials: S
authors.lastname: Irwin
authors.affiliation: Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Barmherzig
authors.affiliation: Department of Neurology, University of California, UCSF Benioff Children's Hospital, San Francisco, CA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Gelfand
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D019468:Disease Management; D018450:Disease Progression; D006761:Hospitals; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis*; D011379:Prognosis; D013577:Syndrome; D014839:Vomiting / Q000175:diagnosis*
keywords: Abdominal migraine; Childhood migraine equivalents; Cyclic vomiting; Cyclical vomiting; Episodic syndromes of childhood; Migraine