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Dizziness and headache: a common association in children and adolescents.
J Child Neurol 2001; 16(10):727-30JC

Abstract

Vertigo has long been recognized by the clinician as a frequent accompanying symptom of the adult migraine syndrome. This association has not been so readily identified in the pediatric population, and, as a consequence, children undergo unnecessary evaluations. We reviewed the charts of all children and adolescents referred for vestibular function testing to the Balance Center at the Barrow Neurological Institute between July 1994 and July 2000 (N = 31). Items analyzed included age, gender, symptoms that prompted the referral, test outcomes, family medical history, and final diagnosis. The most common justification for vestibular testing referral was the combination of dizziness and headache. Other less common reasons were "passing out" episodes, poor balance, and blurred vision. Normal test results were obtained from 70% of patients (n = 22). The most common abnormal test outcome was unilateral vestibular dysfunction (n = 5). Bilateral peripheral vestibular dysfunction was present in three patients. One patient had central vestibular dysfunction. The final diagnoses were vestibular migraine (n = 11), benign paroxysmal vertigo of childhood (n = 6), anxiety attacks (n = 3), Meniere's disease (n = 2), idiopathic sudden-onset sensorineural hearing loss (n = 1), vertigo not otherwise specified (n = 1), familial vertigo/ataxia syndrome (n = 1), and malingering (n = 1); in five patients, no definitive diagnosis was established. The stereotypical patient with vestibular migraine was a teenage female with repeated episodes of headache and dizziness, a past history of carsickness, a family history of migraine, and a normal neurologic examination. Patients who fit this profile are likely to have migrainous vertigo. Consequently, a trial of prophylactic migraine medication should be considered for both diagnostic and therapeutic purposes. Brain imaging and other tests are appropriate for patients whose symptoms deviate from this profile.

Authors+Show Affiliations

Division of Pediatric Neurology, Duke University Medical Center, Durham, NC, 27710, USA. weisleder@pol.netNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11669345

Citation

Weisleder, P, and T D. Fife. "Dizziness and Headache: a Common Association in Children and Adolescents." Journal of Child Neurology, vol. 16, no. 10, 2001, pp. 727-30.
Weisleder P, Fife TD. Dizziness and headache: a common association in children and adolescents. J Child Neurol. 2001;16(10):727-30.
Weisleder, P., & Fife, T. D. (2001). Dizziness and headache: a common association in children and adolescents. Journal of Child Neurology, 16(10), pp. 727-30.
Weisleder P, Fife TD. Dizziness and Headache: a Common Association in Children and Adolescents. J Child Neurol. 2001;16(10):727-30. PubMed PMID: 11669345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dizziness and headache: a common association in children and adolescents. AU - Weisleder,P, AU - Fife,T D, PY - 2001/10/24/pubmed PY - 2002/2/23/medline PY - 2001/10/24/entrez SP - 727 EP - 30 JF - Journal of child neurology JO - J. Child Neurol. VL - 16 IS - 10 N2 - Vertigo has long been recognized by the clinician as a frequent accompanying symptom of the adult migraine syndrome. This association has not been so readily identified in the pediatric population, and, as a consequence, children undergo unnecessary evaluations. We reviewed the charts of all children and adolescents referred for vestibular function testing to the Balance Center at the Barrow Neurological Institute between July 1994 and July 2000 (N = 31). Items analyzed included age, gender, symptoms that prompted the referral, test outcomes, family medical history, and final diagnosis. The most common justification for vestibular testing referral was the combination of dizziness and headache. Other less common reasons were "passing out" episodes, poor balance, and blurred vision. Normal test results were obtained from 70% of patients (n = 22). The most common abnormal test outcome was unilateral vestibular dysfunction (n = 5). Bilateral peripheral vestibular dysfunction was present in three patients. One patient had central vestibular dysfunction. The final diagnoses were vestibular migraine (n = 11), benign paroxysmal vertigo of childhood (n = 6), anxiety attacks (n = 3), Meniere's disease (n = 2), idiopathic sudden-onset sensorineural hearing loss (n = 1), vertigo not otherwise specified (n = 1), familial vertigo/ataxia syndrome (n = 1), and malingering (n = 1); in five patients, no definitive diagnosis was established. The stereotypical patient with vestibular migraine was a teenage female with repeated episodes of headache and dizziness, a past history of carsickness, a family history of migraine, and a normal neurologic examination. Patients who fit this profile are likely to have migrainous vertigo. Consequently, a trial of prophylactic migraine medication should be considered for both diagnostic and therapeutic purposes. Brain imaging and other tests are appropriate for patients whose symptoms deviate from this profile. SN - 0883-0738 UR - https://www.unboundmedicine.com/medline/citation/11669345/Dizziness_and_headache:_a_common_association_in_children_and_adolescents_ L2 - http://journals.sagepub.com/doi/full/10.1177/088307380101601004?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -