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Abdominal Migraine: Prophylactic Treatment and Follow-up

Worawattanakul, Mingmuang; Rhoads, J. Marc; Lichtman, Steven N.; Ulshen, Martin H.

Journal of Pediatric Gastroenterology & Nutrition: January 1999 - Volume 28 - Issue 1 - pp 37-40
Original Articles

Background: Abdominal migraine is a syndrome characterized by recurrent stereotypic episodes of paroxysmal abdominal pain and nausea and/or vomiting with wellness between episodes. It is often associated with a positive family history of migraine and no other apparent underlying disease. The purpose of this study was to report in patients diagnosed with abdominal migraine the outcome, the effect of prophylactic treatment, and the duration of treatment.

Methods: The records of 53 patients who underwent treatment after a diagnosis of abdominal migraine were retrospectively reviewed. Responses to treatment were graded as excellent (cessation of recurrent abdominal pain), fair (persistence of symptoms but milder and less frequent), or poor (no response). Follow-up data were available in 38 patients. Twenty-four patients were treated with propranolol and 12 with cyproheptadine. Four were not treated because of mild and infrequent symptoms.

Results: Among the children treated with propranolol, 18 (75%) had an excellent response, 2 (8%) had a fair response, and 4 (17%) had no response. In those treated with cyprohepatadine, 4 (33%) had an excellent response, 6 (50%) had a fair response, and 2 (17%) had no response. Patients were instructed to continue medication for 6 months or until cycles had stopped. However, 11 of 24 patients (46%) in the propranolol group took medication for less than 6 months and the remaining patients from 6 months 3 years. Six patients in the cyproheptadine group (50%) took medication less than 10 months and the remaining patients for 10 months to 3 years.

Conclusion: Patients with abdominal migraine may benefit from prophylactic treatment with propranolol or cyproheptadine.

Division of Gastroenterology, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Address correspondence and reprint requests to J. Marc Rhoads, Division of Gastroenterology, Department of Pediatrics, CB # 7220, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7220, U.S.A.

Received December 8, 1997; revised April 6 and July 6, 1998; accepted July 7, 1998.

© 1999 Lippincott Williams & Wilkins, Inc.