Benign paroxysmal vertigo of childhood

Headache: The Journal of Head and Face Pain, 1986

SYNOPSIS 21 children suffering from benign paroxysmal vertigo (BPV) were submitted to complete otoneurological examination, including caloric and rotational tabyrinthine stimulation with ENG recording, and to headache provocation tests with nitroglycerin, histamine and fenfluramine. Vestibular responses were normal in all except 2 cases which presented signs of central vestibular impairment at the level of the vestibulo-cerebellar pathways. Headache provocation tests were positive in 10 out of 15 children, and in 5 cases they induced a typical vertiginous attack instead of headache.

Collegium antropologicum, 2012

The aim of the paper is to describe the clinical picture of benign paroxysmal vertigo (BPV) in childhood. BPV in childhood often goes unrecognized in spite of the fact that vertigo and balance disorders are not uncommon in children. Four cases are described with clinical examination findings between the attacks.

Paediatrics and Child Health, 2004

Childrens' complaints of headache and dizziness merit careful evaluation to differentially diagnose a vestibular disorder. Children can manifest with a syndrome mimicking certain classic signs and symptoms of adult vestibular disorders, such as benign paroxysmal positional vertigo, usually associated with aging. Benign paroxysmal vertigo of childhood in which migraine is a key manifestation along with sudden onset of dizziness, is a rare peripheral vestibular disorder in children that is commonly overlooked or misdiagnosed. This review covers the historical development of the diagnosis, evaluation and treatment approaches of benign paroxysmal vertigo of childhood.

International Journal of Pediatric Otorhinolaryngology, 2009

Vertigo and dizziness are common conditions in the adult population that can be rarely seen during childhood; only a few articles describing vertigo in children can be found in literature. Although many causes of vertigo in adulthood occur also in childhood, their frequency may be different. A typical example is benign paroxysmal positional vertigo, the most common peripheral vestibular disorder in adults, which occurs quite uncommonly in children. Furthermore, many common diseases causing vertigo in children may be unique for this population, such as benign paroxysmal vertigo (BPV) of childhood. At present, BPV is defined as a migraine's equivalent, a precursor of migraine or a periodic syndrome of childhood. The International Headache Society also studied this form of vertigo and included the Benign Paroxysmal Vertigo in section 1.3.3. of the International Classification of Headaches (ICHD-2). The present review analyzes recent patho-physiological and clinical evidences regarding idiopathic BPV in children.

Cephalalgia, 1995

We studied the prevalence, causes and clinical features of paroxysmal vertigo (PV) in the well-defined childhood population of the City of Aberdeen. We applied a screening questionnaire to 2165 children (10% random sample of all children 5-15 years of age) attending schools in Aberdeen. Children with a history of at least three episodes of vertigo over the past year due to unknown causes were invited for clinical interview and examination. Children with PV were compared with a group of children with migraine, and with a group of asymptomatic children matched for age and sex. Forty-five children fulfilled the diagnostic criteria for PV (prevalence rate 2.6%, 95% CI 1.9-3.4). They were noted to have clinical features in common with children with migraine, including trigger and relieving factors, associated gastrointestinal and sensory symptoms, vasomotor changes, and a similar pattern of associated recurrent disorders (such as headache, abdominal pain and cyclical vomiting), atopic diseases and travel sickness. Also, they had a twofold increase in the prevalence of migraine (24%) compared with the general childhood population (10.6%). The overlap in the clinical features of PV and migraine suggests that the two conditions are related and that it is reasonable to continue to regard PV as a migraine equivalent. • Epidemiology, migraine, vertigo

Frontiers in Neurology

Introduction“Recurrent Vertigo of Childhood” (RVC) has recently replaced the term “Benign Paroxysmal Vertigo of Childhood” and was defined as recurrent spells of vertigo without evidence of a vestibular migraine of childhood (VMC). RVC and VMC are considered the most frequent causes of vertigo and dizziness in children below 18 years of age. Diagnosis might be challenging since clinical features of RVC and VMC may overlap.ObjectiveThis study aims to characterize clinical and instrument-based findings in patients with RVC and to evaluate the course of the disorder.MethodsWe prospectively collected clinical and instrument-based data of children/adolescents younger than 18 years, who presented at the German Center for Vertigo and Balance Disorders (DSGZ) at the LMU University Hospital in Munich. All patients underwent a comprehensive neurological, ocular motor, vestibular and cochlear examination. Furthermore, findings from follow-up examinations were analyzed.ResultsOverall 42 childre...

European Journal of Paediatric Neurology, 2013

Introduction: Benign Paroxysmal Vertigo of Childhood (BPVC) is a common cause of vertigo in children and it is characterized by recurrent attacks of vertigo without warning resolving spontaneously after minutes to hours. It has been considered the equivalent of migraine in childhood. Methods: Twenty-seven patients diagnosed with BPVC were recruited between 1991 and 1997 with a follow up of at least 15 years. The incidence of migraine, inner ear disorders and family medical history is analyzed. Results: The average age for the onset of the attacks of BPVC was 3 years and 11 months, and for spontaneous resolution, it was around 5 years and 7 months. The average age for follow up was 18 years. Nine patients developed migraine during adulthood. Nineteen of them had a family history of migraine. Conclusion: We have observed that the prevalence of migraine in patients that had been diagnosed with BPVC is higher than in the general population, which leads us to propose BPVC as a precursor of migraine during childhood.

Bratislava Medical Journal, 2012

Children complaints dizziness merit meticulous evaluation to differentially diagnose a vestibular disease. A syndrome mimicking certain classic signs and symptoms of adult vestibular disorders may be presents in children, such as benign paroxysmal positional vertigo, usually associated with aging. Benign paroxysmal vertigo, in which migraine is a manifestation, with sudden onset of dizziness is a rare peripheral vestibular disorder that is commonly ignored or misdiagnosed. This review covers the development of the diagnosis, evaluation and treatment approaches of vertigo of childhood, a valid support for physician that approach dizzy children (Ref. 25).

Vertigo is not common in the pediatric age group, but probably more often than was formerly thought. Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. It consists of the short duration of vertigo attacks found in a definite head position. The exact cause of BPPV is related to the idiopathic detachment of otoconia from the utricular membrane. The prevalence of BPPV in children is lower than in the adult age group. In children with BPPV, the symptoms consist of transitory rotational vertigo and torsional/ vertical/ horizontal or mixed nystagmus, depending on the position of the intra-labyrinthine otoliths, with latency and intensity in a typical crescendo-decrescendo pattern and it is exhaustible, reversible and fatiguing similar to adults. The diagnosis of BPPV can be accurately done by taking a detailed medical history, audiogram, and by use of positional testing. In children, BPPV can be successfully diagnosed and treated. In most cases, pediatric patients could not express details of their symptoms, and clinicians cannot always obtain adequate medical histories and determine their objective signs. So, it is not easy to study the BPPV in children. There are only a few articles describing BPPV in the pediatric age group, and therefore this subject is not well known to most otolaryngologists and clinicians. This review article discusses the epidemiology, etiopathology, clinical manifestations, diagnosis, and treatment of BPPB in the pediatric age group.

International Journal of Pediatric Otorhinolaryngology, 2006

Vertigo in childhood is a complaint consisting of a wide spectrum of diagnoses. The aim of this study was to evaluate pediatric patients with vertigo with normal eardrum and middle ear findings and discuss the differential diagnoses.Patient records of 50 children under 18 years of age with vertigo as the chief complaint, examined at the Baskent University, Research and Application Centers at Konya and Adana otorhinolaryngology clinics between May 2003 and October 2005 were retrospectively reviewed. The questionnaires, laboratory tests including blood samples, audiological and vestibular tests, and final diagnoses were analyzed. Patients with perforated eardrums, otitis media with effusion, and acute upper respiratory tract infections were not included in the study.The study group consisted of 50 patients (33 females, 66%; 17 males, 34%), between 4 and 17 years of age (mean age, 11.5 ± 3.9 years). Severe sensorineural hearing loss was present in one patient unilaterally (2%) and one patient bilaterally (2%). Bilateral low-frequency sensorineural hearing loss was present in one patient (2%). Electronystagmography revealed central vestibular abnormalities in three patients (6%). Canal paresis was established in six patients (12%). The Dix–Hallpike test was positive in six patients (12%). The most frequent cause of vertigo was migraine, occurring in 34% of patients (n = 17). Other less-frequent etiologies of vertigo were benign paroxysmal vertigo (n = 6; 12%), benign paroxysmal positional vertigo (n = 6; 12%), psychogenic vertigo (n = 5; 10%), epilepsy (n = 3; 6%), metabolic disorders (n = 3; 6%), vestibular neuritis (n = 2; 4%), Meniere's disease (n = 1; 2%), perilymphatic fistula (n = 1; 2%), amblyopia (n = 1; 2%), and unclassifiable (n = 5; 10%).Migraine was found to be the most frequent presenting diagnosis in childhood vertigo, although several peripheral vestibular disorders also were diagnosed. Evaluation of vertigo in childhood should begin with a thorough neuro-otologic evaluation and include other relevant multidisciplinary team members as needed to avoid unnecessary effort and cost.