1.6.1.2 Abdominal migraine

A 12-year-old girl has had seven broadly similar attacks of abdominal pain over the last two years. Her pain is consistently described as a dull ache rather than sharp or cramping, and she rates the intensity as moderate throughout, uncomfortable enough to keep her off school but not incapacitating. She stops eating entirely once an attack begins and has vomited during most of these episodes, sometimes several times in a day. The current attack has now lasted close to two and a half days, around 58 hours by her mother's count, longer than her usual pattern. Between attacks she is completely well, back to netball training within a day or two with no residual symptoms. Despite thorough review, no other cause has been identified for these episodes.