Çocuklarda Vertigo Etiyolojisi, Çocukluk Çağı Benign Paroksismal Vertigosu ve Migren Ilişkisi

Abstract

Vertigo in children has received much less attention in the literature than vertigo in adults and there is no standart algorithm for evaluation of these children. The most common reason of vertigo in childhood, benign paroxysmal vertigo of childhood (BPVC) is thought to be a migraine precursor. The aim of this study was to describe the characteristics of vertigo in pediatric patients presenting to a tertiary neurology clinic and to investigate the relationship between BPVC and migraine. All patients younger than 18 years of age and presenting with vertigo to Hacettepe University Ihsan Dogramaci Children?s Hospital Neurology Unit between January 1996-January 2012 were included in the study. These patients were retrospectively analysed through the patient files and follow-up data were obtained with phone interviews. One hundred patients with a mean age of 7,5 years were evaluated in our study. The most common symptoms associated with vertigo were headache (20%) and nausea (17%). The most common vertigo etiologies were BPVC (39%), psychogenic vertigo (21%), epileptic vertigo (15%), and migraine-associated vertigo (MAV) (11%). The most common etiology was BPVC in children ?5 years of age, while it was psychogenic vertigo in older children. Staring episodes were more common in epileptic vertigo patients (p=0,021) while headache was more commonly associated with MAV (p<0,001). Vertigo attacks lasting more than five minutes were less common in BPVC patients compared with others (p=0,013). Six (20%) out of 30 BPVC patients contacted through phone interviews were experiencing migraine type headaches. An algorithm for evaluation of children presenting with vertigo was formed based on data obtained from this study and the literature. When this algorithm was applied to 30 randomly selected cases from this series, 23 (76,6%) were correctly diagnosed. In most of the cases of vertigo disorders in children, a thorough medical history and a detailed physical examination, neurological examination and audiological evaluation are sufficient for accurate diagnosis. A standart algorithm for evalution of this patient group can help with the correct diagnosis and treatment.