Neurologic investigations of childhood abdominal migraine: a combined electrophysiologic approach to diagnosis

Abstract

Neurologic studies of childhood migraine, including imaging techniques and electrophysiology, have identified a number of abnormalities, but none of high specificity. Therefore, a diagnostic marker for childhood migraine and its equivalents remains elusive. In this study a combined electrophysiologic approach is assessed, using measurements of visually provoked beta-activity, high-frequency photic following responses, and visually stimulated event-related potentials. Eighteen children younger than 10 years of age with abdominal migraine and/or cyclic vomiting syndrome were investigated with these techniques. They were compared with the responses from a number of control groups, including a group diagnosed as childhood migraine with or without aura. Individually, each investigation yielded high sensitivities but low specificities ( < 50%). However, when these techniques were used in combination the specificity for migraine rose to > 90%. There was no significant difference between abdominal migraineurs and those with migraine with or without aura in any of the parameters studied. This combined approach is potentially useful in the diagnosis of abdominal migraine and supports the view that abdominal migraine can be classed as a true childhood migraine equivalent.