Abstract
Benign paroxysmal vertigo of childhood (BPVC) is one of the most common causes of vertigo attacks in pediatric patients. Some patients with BPVC suffer from migraine in the future, so that the possibility of migraine is an important consideration in children with recurrent vertigo. Recently, novel diagnostic criteria for vestibular migraine and recurrent vertigo of childhood were published for “Vestibular Migraine of Childhood (VMC)”, “probable Vestibular Migraine of Childhood (probable VMC)” and “Recurrent Vertigo of Childhood (RVC)”.
In the present study, we evaluated patients with vertigo or dizziness who were less than 18 years old, focusing particularly on concomitant headaches. The medical records of 69 patients were reviewed retrospectively. The predominant diagnoses were VMC (n = 4) , probable VMC (n = 10) , RVC (n = 22), orthostatic dysregulation (OD; n = 12), central vertigo and vertigo related to infectious disorder (n = 4 each), psychogenic vertigo (n = 3), benign paroxysmal positional vertigo (BPPV; n = 2), Meniere’s disease (n = 1), and other conditions (n = 7).
Of the total, 33 subjects had concomitant headaches and 13 did not, and the presence/absence of headache could not be confirmed in the remaining 23 subjects. Of the 33 patients with concomitant headaches, 13 were diagnosed as having migraine; 4 as having VMC, 3 as having probable VMC, 3 as having OD, and one each as having central vertigo, infectious disorder, and BPPV. Differentiation between migraine and OD is sometimes difficult, because patients with OD also frequently present with headaches, thus indicating the importance of collaborative intervention with a pediatrician.
A significantly larger number of patients reported having concomitant headaches if they were asked about it, as compared with the number among those who were not directly asked the question by the physician. This result indicates the possibility that prompt history taking about the presence/absence of headaches may influence the diagnostic results in pediatric vertigo patients. It is therefore essential to ask pediatric patients with recurrent vertigo if they suffer from headaches or not.
