Ezgi Deniz Batu1, Banu Anlar2, Meral Topçu3, Güzide Turanlı4, Sabiha Aysun5. 1. Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey. Electronic address: ezgidenizbatu@yahoo.com. 2. Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address: banlar@hacettepe.edu.tr. 3. Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address: mtopcu@hacettepe.edu.tr. 4. Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address: gturanli@hacettepe.edu.tr. 5. Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address: saysun@hacettepe.edu.tr.
Abstract
OBJECTIVE: Evaluation and management of vertigo in children vary between institutions and medical specialties. The aim of this study is to describe the characteristics of vertigo in children presenting to a pediatric neurology referral center and to investigate the relationship between vertigo and migraine. STUDY DESIGN: Patients <18 years old presenting with vertigo to Hacettepe University Ihsan Dogramaci Children's Hospital Neurology Unit between January 1996-January 2012 were included (n = 100). Data were obtained from patient files and phone interviews. RESULTS: Mean age was 7.5 years. The most common etiological groups were benign paroxysmal vertigo of childhood (BPVC) (39%), psychogenic vertigo (21%), epileptic vertigo (15%), and migraine-associated vertigo (MAV) (11%). BPVC was the most common diagnosis in children ≤5 years of age while psychogenic vertigo prevailed in children >5 years. Staring episodes characterized epileptic vertigo patients (p = 0.021) while headache was more often described by MAV patients (p < 0.001). Vertigo attacks >5 min were uncommon in BPVC patients compared to others (p = 0.013). Twenty percent of BPVC patients contacted through phone interviews were experiencing migraine type headaches that started at a median age of 7.5 years. An algorithm for evaluation of children with vertigo was formed based on data obtained from this study and the literature. When this algorithm was applied to 100 cases of this series, 88 (88%) were correctly diagnosed. CONCLUSION: While most vertigo cases in children can be diagnosed accurately by a detailed medical history, physical and neurological examination, a standard algorithm can help with the correct classification.
OBJECTIVE: Evaluation and management of vertigo in children vary between institutions and medical specialties. The aim of this study is to describe the characteristics of vertigo in children presenting to a pediatric neurology referral center and to investigate the relationship between vertigo and migraine. STUDY DESIGN:Patients <18 years old presenting with vertigo to Hacettepe University Ihsan Dogramaci Children's Hospital Neurology Unit between January 1996-January 2012 were included (n = 100). Data were obtained from patient files and phone interviews. RESULTS: Mean age was 7.5 years. The most common etiological groups were benign paroxysmal vertigo of childhood (BPVC) (39%), psychogenic vertigo (21%), epileptic vertigo (15%), and migraine-associated vertigo (MAV) (11%). BPVC was the most common diagnosis in children ≤5 years of age while psychogenic vertigo prevailed in children >5 years. Staring episodes characterized epileptic vertigo patients (p = 0.021) while headache was more often described by MAV patients (p < 0.001). Vertigo attacks >5 min were uncommon in BPVCpatients compared to others (p = 0.013). Twenty percent of BPVCpatients contacted through phone interviews were experiencing migraine type headaches that started at a median age of 7.5 years. An algorithm for evaluation of children with vertigo was formed based on data obtained from this study and the literature. When this algorithm was applied to 100 cases of this series, 88 (88%) were correctly diagnosed. CONCLUSION: While most vertigo cases in children can be diagnosed accurately by a detailed medical history, physical and neurological examination, a standard algorithm can help with the correct classification.