Background: Abdominal migraine in adults is
poorly understood and often undiagnosed. It results
in recurrent episodes of abdominal pain associated
with nausea, vomiting, and retching. Abdominal
myofascial pain syndrome is a common
but unrecognized cause of chronic abdominal wall
pain. Abdominal migraine can result in abdominal
myofascial pain syndrome due to either trauma
to the rectus abdominis muscle from excessive
retching or due to viscerosomatic convergence
from underlying esophageal-gastric inflammation.
Objective: Our objective is to present a case
report of undetected abdominal migraine in an
adult patient presenting with abdominal myofascial
pain syndrome and its diagnosis following
successful management of abdominal myofascial
pain syndrome.
Study Design: This case report describes a patient
presenting with 3 different types of abdominal
pain to a pain medicine clinic.
Setting: The patient was seen in a tertiary pain
medicine clinic based in a university teaching
hospital.
Methods: This report describes the successful
management of abdominal myofascial pain syndrome
by trigger point treatment with depot steroids
followed by pulsed radiofrequency treatment.
Results: Successful management of abdominal
myofascial pain syndrome resulted in subsequent
diagnosis of abdominal migraine. There was
improvement reported in pain intensity scores,
quality of life, anxiety, and depression scores
following the interventional management of abdominal
myofascial pain syndrome as well as
abdominal migraine.
Limitations: This report represents a single
patient presenting with a previously unreported
combination of persistent abdominal pain.
Conclusion: Abdominal migraine and abdominal
myofascial pain syndrome are often unrecognized
conditions that result in significant health care
utilization. Undiagnosed abdominal migraine can
result in abdominal myofascial pain syndrome and
this can result in a delay in the correct diagnosis
of abdominal migraine.
Key words: Abdominal migraine, abdominal
myofascial pain syndrome, chronic abdominal
wall pain, trigger point treatment, viscerosomatic
convergence
1851 The Ever-Mysterious Cyclical Vomiting Syndrome (CVS) and Abdominal Migraine: Recognition and Successful Management Strategies Illustrated by a Case Report