Prevalence and Clinical Features of Abdominal Migraine in Children: A Systematic Review

Abstract

Background: Abdominal migraine is a functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain with migraine features, predominantly affecting children. Despite increasing recognition, its prevalence and clinical characteristics remain underexplored and frequently misunderstood. Objective: To systematically review the literature on the prevalence and clinical features of abdominal migraine in children. Methods: A structured search of PubMed, Scopus, and Web of Science was conducted for articles published between 2000 and 2024. Inclusion criteria were peer- reviewed studies involving children (<18 years) that reported on the prevalence and/or clinical presentation of abdominal migraine. Exclusion criteria included case reports, non-English articles, and studies focused on other types of headaches or secondary gastrointestinal disorders. The review followed the PRISMA 2020 guidelines for systematic reporting. Results: A total of 34 studies met the inclusion criteria. The prevalence of abdominal migraine among pediatric populations ranged from 1% to 9%, with variation depending on diagnostic criteria and study population. The condition predominantly affects school- aged children, with a slight female predominance. Key clinical features include midline or periumbilical abdominal pain, associated nausea, vomiting, pallor, and headache. Many children also have a personal or family history of migraines. Diagnostic challenges persist due to symptom overlaps with other gastrointestinal disorders and variability in awareness among clinicians. Conclusion: Abdominal migraine is an underdiagnosed but significant cause of recurrent abdominal pain in children. Recognition of its characteristic features and use of standardized diagnostic criteria are essential for timely diagnosis and management. Further epidemiological studies are needed to clarify its true prevalence and natural history.