Adult Abdominal Migraine Presenting with Abdominal Myofascial Pain Syndrome: Case Report

Background: Abdominal migraine in adults ispoorly understood and often undiagnosed. It resultsin recurrent episodes of abdominal pain associatedwith nausea, vomiting, and retching. Abdominalmyofascial pain syndrome is a commonbut unrecognized cause of chronic abdominal wallpain. Abdominal migraine can result in abdominalmyofascial pain syndrome due to either traumato the rectus abdominis muscle from excessiveretching or due to viscerosomatic convergencefrom underlying esophageal-gastric inflammation.Objective: Our objective is to present a casereport of undetected abdominal migraine in anadult patient presenting with abdominal myofascialpain syndrome and its diagnosis followingsuccessful management of abdominal myofascialpain syndrome.Study Design: This case report describes a patientpresenting with 3 different types of abdominalpain to a pain medicine clinic.Setting: The patient was seen in a tertiary painmedicine clinic based in a university teachinghospital.Methods: This report describes the successfulmanagement of abdominal myofascial pain syndromeby trigger point treatment with depot steroidsfollowed by pulsed radiofrequency treatment.Results: Successful management of abdominalmyofascial pain syndrome resulted in subsequentdiagnosis of abdominal migraine. There wasimprovement reported in pain intensity scores,quality of life, anxiety, and depression scoresfollowing the interventional management of abdominalmyofascial pain syndrome as well asabdominal migraine.Limitations: This report represents a singlepatient presenting with a previously unreportedcombination of persistent abdominal pain.Conclusion: Abdominal migraine and abdominalmyofascial pain syndrome are often unrecognizedconditions that result in significant health careutilization. Undiagnosed abdominal migraine canresult in abdominal myofascial pain syndrome andthis can result in a delay in the correct diagnosisof abdominal migraine.Key words: Abdominal migraine, abdominalmyofascial pain syndrome, chronic abdominalwall pain, trigger point treatment, viscerosomaticconvergence