HeadWise HeadWise: Volume 2, Issue 2 - Page 26

growing pains 5. CYCLIC VOMITING/ABDOMINAL MIGRAINE How Common Is It? They’re rare, sure. But just how likely is your child to experience one of these strange disorders compared to more common conditions? Here are the numbers. Strange symptom: bouts of vomiting These two conditions are often considered together, as both tend to occur more often among families where there is a history of migraine and both involve the gastrointestinal tract. Cyclic vomiting, which typically occurs in younger children with an average age of six, involves recurrent episodes of repeated vomiting, at least five times per hour. Between bouts of vomiting, children may report feeling fine but they may be dehydrated. Migraine is not typically part of cyclic vomiting; however, most of these children develop migraines when they get older. Children with abdominal migraine tend to be a bit older than those with cyclic vomiting. They experience intermittent attacks of vague stomachaches that are not associated with either diarrhea or constipation. Research from the March 2011 issue of the journal Headache suggests that four to 15 percent of children referred to a specialist for abdominal pain have abdominal migraine. NOT TO BE TOYED WITH Headache 37-51% of all children Migraine 3.5-10% of all children Basilar migraine 3-19% of children with migraine Cyclic vomiting  0.0004-0.02% of all children Abdominal migraine 2  0% of children with migraine Hemiplegic migraine and “Alice in Wonderland” syndrome are so rare among children that incidence has not been widely documented. Any childhood headache that is recurrent, worsening or interfering with the child’s activities should be checked out. But if your child experiences any of the stranger symptoms described above, a trip to the emergency room is mandatory to rule out more serious conditions. The emergency room physician will want to gather all relevant information to ensure that symptoms like dizziness and weakness are not a sign of something worse like stroke, brain tumor, ulcerative colitis, drug ingestions, severe hydration, meningitis, etc. Your child may need blood work, a CT scan or an MRI to rule out the more serious conditions. Once a proper diagnosis is made, it’s important to consult with a headache specialist to develop a treat24 HEAD WISE | Volume 2, Issue 2 • 2012 ment plan that the family and child can work through together. Treatment for these rare migraine disorders is the same as treatment offered to children with other types of migraines. This might include ice packs, magnesium, NSAIDs, abortive medications and anticonvulsants in IV form. It should be noted that, while it’s less likely, adults can also experience these conditions. In these cases, it is even more important for an adult to see a physician for a diagnosis, as it is more likely in the adult population that these symptoms are a sign of something more serious, like a stroke. HW HOWARD JACOBS, MD, is co-director of the Pediatric Headache Clinic, University of Maryland School of Medicine, Baltimo ɔ5((