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Caloric and vestibular evoked myogenic potential tests in evaluating children with benign paroxysmal vertigo
Chun-Hsiang Chang1, Yi-Ho Young
1Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Vestibular evoked myogenic potential (VEMP) and caloric tests reveal significant vestibular abnormalities in children with benign paroxysmal vertigo (BPV), similar to basilar migraine.
Area of Science:
- Pediatric Neurology
- Vestibular System Disorders
- Otolaryngology
Background:
- Benign paroxysmal vertigo (BPV) in children can present with complex vestibular symptoms.
- Basilar type migraine shares some clinical features with vestibular disorders.
- Understanding shared vestibular features can aid in diagnosis and management.
Purpose of the Study:
- To investigate vestibular system abnormalities in children with BPV.
- To compare vestibular features of BPV in children with those of basilar type migraine in adults.
- To assess the utility of caloric and VEMP tests in diagnosing pediatric BPV.
Main Methods:
- Twenty children diagnosed with BPV and twenty healthy controls were enrolled.
- Standard audiometry, caloric testing, and VEMP testing were performed on all participants.
- BPV diagnosis followed the International Classification of Headache Disorder, second edition criteria.
Main Results:
- BPV children exhibited normal hearing bilaterally.
- Caloric test abnormalities were found in 35% of BPV children, while VEMP tests showed 50% abnormality.
- Combined caloric and VEMP testing revealed abnormalities in 70% of BPV children, comparable to basilar migraine.
Conclusions:
- A significant proportion of children with BPV demonstrate vestibular abnormalities.
- Vestibular evoked myogenic potential and caloric tests highlight similarities between pediatric BPV and adult basilar migraine.
- These tests are valuable supplementary diagnostic tools for evaluating BPV in children.
Objective:
This study applied caloric and vestibular evoked myogenic potential (VEMP) tests to evaluate whether children with benign paroxysmal vertigo (BPV) shares similar vestibular features with basilar type migraine.
Methods:
Twenty subjects of each group including healthy and BPV children were enrolled in this study. Each subject underwent audiometry, caloric and VEMP tests. Diagnosis of BPV was based on the International Classification of Headache Disorder, second edition.
Results:
All BPV children had normal hearing, bilaterally. Caloric test revealed normal responses in 13 patients and abnormal responses in 7 patients (35%). VEMP test showed 50% abnormality in BPV children, including absent and delayed responses. However, when results of caloric and VEMP testing were considered together, 70% of BPV children had abnormality, exhibiting non-significant difference compared with 75% abnormality in basilar type migraine.
Conclusions:
A combination of caloric and VEMP results reveals higher abnormality (70%) in BPV children, sharing similar features with basilar type migraine in adults, given the similarity of the two disorders. Thus, caloric and VEMP tests may serve as supplementary diagnostic tools in evaluating children with BPV.
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