Less common
varieties of migraine are the so-called migraine equivalents and unusual
varieties of complicated migraine. "Migraine equivalent" is a
term used to denote conditions or symptomatology believed to be
migrainous in origin but without the typical history of either classic
or common migraine headache. The most well-recognized type of migraine
equivalent is abdominal migraine, in which cyclical vomiting, periodic
attacks of nausea, or abdominal pain occur (usually in children or in
adolescents). These patients experience more typical attacks of migraine
in later life. If the past history of migraine patients is investigated,
a history of cyclical vomiting is far more commonly found than in a
control headache population. Very rarely true abdominal migraine occurs
in adult life. In this situation there may be sudden severe abdominal
pain with vomiting and even abdominal rigidity. The usual brevity of the
attack or previous similar benign episodes or strong history of migraine
help confirm the diagnosis. Other migraine equivalents include periodic
diarrhea, fever, mood changes, and possibly attacks of chest pain known
as precordial migraine. Acute confusional states have been attributed to
migraine in juveniles.
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