Clinical factors associated with vestibular impairment and migraine in a multi-ethnic pediatric cohort

Peripheral vestibular disease primarily involves the part of the inner ear that controls balance and may affect the physical and psychological well-being of children. Peripheral vestibular disease can be challenging to assess in children due to the difficulty of patients with verbalization of symptoms, variety of clinical presentations, and the involvement of other organ systems of balance. This cross-sectional study aimed to identify clinical factors that are associated with vertigo and migraine in pediatric patients.

The clinical records of 292 children seen at the specialty clinic for an assessment of dizziness were reviewed for demographic variables, medical history, imaging, and audiovestibular symptoms and tests. Standard statistical testing was performed.

Logistic regression analysis showed that having abnormal MRI findings (odds ratio [OR] = 0.74; p = 0.001), a previous referral diagnosis of "nystagmus" (OR = 0.58; p = 0.04), attention deficit hypersensitivity or autism spectrum disorder (OR = 0.70; p = 0.007), and migraine (OR = 0.71; p = 0.0004) were associated with a less likely diagnosis of peripheral vertigo. On the other hand, cardiovascular conditions (OR = 2.64; p = 0.02) were associated with migraine in patients with vertigo.

Our findings suggest that thorough evaluation for neurologic and cardiovascular disorders is important in order to improve diagnosis and management of vertigo and dizziness in children.