Identifying potential risk factors for migraine-related vertigo in children

The aim of this study was to investigate established migraine-associated factors in children with idiopathic episodic vertigo.

A retrospective cohort study was conducted on 30 children diagnosed with idiopathic episodic vertigo. Several migraine-associated clinical manifestations were evaluated. In addition, the presence of headache, the age of onset for both headache and vertigo, and the criteria for vestibular migraine were also considered. Data were compared to those of a control group, which did not exhibit vertigo.

A family history of migraine, episodic syndromes, sleep disorders and motion sickness disorder were significantly more frequent in children with episodic vertigo (p = 0.001). Headache occurred in 7 patients (23.3%). The mean age at onset of the first vertigo episode was 8.57 ± 2.11, which was significantly lower (p < 0.0001) than the average age of onset for headache, recorded at 12.71 ± 1.50. Migraine headache was not reported before the age of 10 and never preceded the onset of vertigo. Only three patients (10%) met the diagnostic criteria for vestibular migraine, all of whom were older than 14 years.

A thorough assessment of the migraine-associated factors investigated in this study may improve the evaluation of children with episodic vertigo. The readily accessible data, whether obtained directly or with parental assistance, support the hypothesis of a migraine-related origin of the symptoms. This investigation is essential, particularly during the pre-pubertal age, when headaches are frequently absent, thereby limiting the ability to fulfil the diagnostic criteria for vestibular migraine.