Abdominal Pains and Migraine in Autism

This blog was based on an article that I had previously published. I had received many complaints from patients that appeared to reflect headaches. Knowing some of the involved neuropathology, I thought that migraines could be comorbid to autism. Ever since a number of articles have approached this subject, probably the most important of which is:

The presence of migraines and its association with sensory hyperreactivity and anxiety symptomatology in children with autism spectrum disorder.
Sullivan JC, Miller LJ, Nielsen DM, Schoen SA.

Abstract

Migraine headaches are associated with sensory hyperreactivity and anxiety in the general population, but it is unknown whether this is also the case in autism spectrum disorders. This pilot study asked parents of 81 children (aged 7-17 years) with autism spectrum disorders to report their child’s migraine occurrence, sensory hyperreactivity (Sensory Over-Responsivity Inventory), and anxiety symptoms (Spence Child Anxiety Scale). Children with autism spectrum disorders who experienced migraine headaches showed greater sensory hyperreactivity and anxiety symptomatology (p < 0.01; medium effect size for both) than those without migraines. Sensory hyperreactivity and anxiety symptomatology were additionally correlated (ρ = 0.31, p = 0.005). This study provides preliminary evidence for a link between migraine headaches, sensory hyperreactivity, and anxiety symptomatology in autism spectrum disorders, which may suggest strategies for subtyping and exploring a common pathogenesis.

Cortical Chauvinism

About 17 years ago, when I acquired a personal interest in autism, the link to abdominal symptoms was mentioned in the literature but readily dismissed as coincidental. Throughout the years there has been increasing interest on the subject fueled, curiously enough, by highly speculative hypotheses often backed by little supportive evidence, e.g., leaky gut syndrome, autistic enterocolitis. The reason for this blog is that, if such a relationship proved to be non-coincidental, I would have sought for a simpler  explanation. In essence the burden of proof should make use of the most parsimonious medically acceptable proposition, doing otherwise would lead to a type of infinite regress. In the case of autism and abdominal pains I would have first started by eliminating a possible link to migraines.

Both autism and migraines are conditions that are entirely diagnosed based on clinical history. In some children with family history of migraine,s abdominal pains…

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