does the symptom imply an unknown mechanism of migraine?
Abdominal migraine is one subcategory of migraine-related syndromes. Migraine is sometimes associated with facial ecchymosis, which may be accounted for by trigeminovascular activation. However, the precise mechanism of this concurrence remains unknown. Here, we describe a 9-year-old girl, who presented ecchymosis of the legs and buttock associated with recurrent, severe, non-localized midline abdominal pain. The patient has positive family history of migraine. Investigations during an attack revealed no obvious abnormalities. According to the International Classification of Headache Disorders (Second Edition), she was diagnosed with abdominal migraine. Her abdominal pain was relieved with sumatriptan, a migraine-specific serotonin(1B/1D) agonist. The ecchymosis always occurred in conjunction with abdominal pain and tended to regress after pain relief. In contrast to the local trigeminovascular activation theory that explains the ecchymosis in a migraine-related condition, the findings