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Vestibular Migraine and Recurrent Vertigo in Children: A Diagnostic Focus From a Tertiary Hospital Study
Qunying Zhang1, Yi Du2, Xingjian Liu2
1College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China; Department of Neurology, Qinghe Central Hospital, Xingtai City, Hebei Province, China.
Insights
Pediatric vertigo diagnoses like Vestibular Migraine of Childhood (VMC) and Recurrent Vertigo of Childhood (RVC) show distinct symptoms and vestibular test results, aiding in better diagnosis and treatment.
Area of Science:
- Otolaryngology
- Pediatric Neurology
- Vestibular Disorders
Background:
- Pediatric vertigo diagnosis requires refinement, especially for Vestibular Migraine of Childhood (VMC), probable VMC (pVMC), and Recurrent Vertigo of Childhood (RVC).
- Delineating clinical characteristics and prevalence is crucial for improving diagnostic precision and treatment strategies in pediatric vestibular disorders.
Purpose of the Study:
- To enhance diagnostic accuracy for pediatric vertigo conditions, including VMC, pVMC, and RVC.
- To identify unique and overlapping clinical features and prevalence rates to refine diagnostic criteria and therapeutic approaches.
Main Methods:
- A retrospective analysis of 102 pediatric patients (aged 5-18) diagnosed with vertigo between January 2019 and December 2023.
- Patients were categorized into VMC, pVMC, RVC, and indeterminate groups, undergoing audiometry and vestibular function tests (vHIT or caloric testing).
- Data analysis was performed using IBM SPSS 20.0 to compare clinical characteristics and test results across diagnostic groups.
Main Results:
- Recurrent Vertigo of Childhood (RVC) was the most common diagnosis (51.0%), followed by probable VMC (31.4%), with VMC and indeterminate categories at 8.8% each.
- Nausea and vomiting were prevalent in VMC and pVMC, while VMC cases more frequently presented with cochlear symptoms like tinnitus and hearing loss.
- Vestibular testing revealed specific anomalies: VMC showed more video head impulse test (vHIT) abnormalities, whereas RVC exhibited more caloric test anomalies, despite no significant overall group differences.
Conclusions:
- The study underscores the heterogeneity of pediatric vestibular disorders, with distinct clinical and audiological profiles for VMC, pVMC, and RVC.
- Recognizing overlapping symptoms and specific vestibular test findings is essential for accurate diagnosis and tailored treatment.
- Further research is needed to refine diagnostic criteria and optimize management strategies for these pediatric conditions.
Background:
To improve diagnostic precision in pediatric vertigo, particularly in Vestibular Migraine of Childhood (VMC), probable VMC (pVMC), Recurrent Vertigo of Childhood (RVC), and unspecified categories, by delineating clinical characteristics and prevalence to refine diagnostics and treatments.
Methods:
Retrospective analysis of 102 pediatric patients (five to 18 years; 46 females, 56 males) at the Dizziness Center of the Otolaryngology Department in a tertiary-level hospital from January 2019 to December 2023. Patients were classified into VMC, pVMC, RVC, and indeterminate groups. Evaluations included audiometry and vestibular tests (video head impulse test [vHIT] or caloric testing), conducted in the audiology unit and vestibular testing laboratory. Data were analyzed using IBM SPSS 20.0.
Results:
Diagnoses were 8.8% VMC, 31.4% pVMC, 51.0% RVC, and 8.8% indeterminate. Nausea and vomiting were common in VMC and pVMC; cochlear symptoms like tinnitus and hearing loss predominated in VMC. Although vestibular testing showed no significant group differences, VMC had more vHIT abnormalities and RVC had more caloric test anomalies.
Conclusions:
This study highlights the need for comprehensive diagnostics in pediatric vestibular disorders, revealing unique and overlapping traits across VMC, pVMC, and RVC. Insights call for further research to refine diagnostic criteria and improve treatment methods.
