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Evaluation and management of vestibular migraine in children: Experience from a pediatric vestibular clinic.
Eur J Paediatr Neurol. 2016 Jan; 20(1):85-92.EJ

Abstract

OBJECTIVE

Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatric population. The aim of this study was to evaluate the diagnostic features and response to therapy of VM in children managed at a pediatric vestibular clinic.

METHODS

Twenty-eight patients ≤18 years old with a diagnosis of VM were identified from 208 patients seen at the Balance and Vestibular Program at Boston Children's Hospital from July 2012-July 2014, after excluding 12 patients with a history of major otologic or neurologic surgery, recent concussion, or additional vestibular disorders. Patients' electronic medical records and testing results were retrospectively reviewed.

RESULTS

Patients ranged in age from 9 to 18 years old (mean 14.48). All included patients met criteria for definite (n = 25) or probable (n = 3) VM as defined by the International Classification of Headache Disorders. Rotary chair (n = 17), caloric (n = 8), cervical vestibular evoked myogenic potential (n = 16), and video head impulse (n = 3) tests were normal. Medications effectively reduced reported vestibular symptoms in 88% of those treated with tricyclics (n = 8), 86% of those treated with cyprohepatadine (n = 7), 80% of those treated with topiramate (n = 5), 80% of those treated with triptans (n = 10), and 25% of those treated with gabapentin (n = 4).

CONCLUSIONS

Vestibular migraine is a common cause of vertigo in the pediatric population that is frequently responsive to medical therapy.

Authors+Show Affiliations

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA. Electronic address: jacob.brodsky@childrens.harvard.edu.Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26521123

Citation

Brodsky, Jacob R., et al. "Evaluation and Management of Vestibular Migraine in Children: Experience From a Pediatric Vestibular Clinic." European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, vol. 20, no. 1, 2016, pp. 85-92.
Brodsky JR, Cusick BA, Zhou G. Evaluation and management of vestibular migraine in children: Experience from a pediatric vestibular clinic. Eur J Paediatr Neurol. 2016;20(1):85-92.
Brodsky, J. R., Cusick, B. A., & Zhou, G. (2016). Evaluation and management of vestibular migraine in children: Experience from a pediatric vestibular clinic. European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, 20(1), 85-92. https://doi.org/10.1016/j.ejpn.2015.09.011
Brodsky JR, Cusick BA, Zhou G. Evaluation and Management of Vestibular Migraine in Children: Experience From a Pediatric Vestibular Clinic. Eur J Paediatr Neurol. 2016;20(1):85-92. PubMed PMID: 26521123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation and management of vestibular migraine in children: Experience from a pediatric vestibular clinic. AU - Brodsky,Jacob R, AU - Cusick,Brandon A, AU - Zhou,Guangwei, Y1 - 2015/10/22/ PY - 2015/07/09/received PY - 2015/09/09/revised PY - 2015/09/28/accepted PY - 2015/11/2/entrez PY - 2015/11/2/pubmed PY - 2016/8/17/medline KW - Benign paroxysmal vertigo of childhood KW - Migraine associated vertigo KW - Migrainous vertigo KW - Pediatric vertigo KW - Vestibular migraine SP - 85 EP - 92 JF - European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society JO - Eur J Paediatr Neurol VL - 20 IS - 1 N2 - OBJECTIVE: Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatric population. The aim of this study was to evaluate the diagnostic features and response to therapy of VM in children managed at a pediatric vestibular clinic. METHODS: Twenty-eight patients ≤18 years old with a diagnosis of VM were identified from 208 patients seen at the Balance and Vestibular Program at Boston Children's Hospital from July 2012-July 2014, after excluding 12 patients with a history of major otologic or neurologic surgery, recent concussion, or additional vestibular disorders. Patients' electronic medical records and testing results were retrospectively reviewed. RESULTS: Patients ranged in age from 9 to 18 years old (mean 14.48). All included patients met criteria for definite (n = 25) or probable (n = 3) VM as defined by the International Classification of Headache Disorders. Rotary chair (n = 17), caloric (n = 8), cervical vestibular evoked myogenic potential (n = 16), and video head impulse (n = 3) tests were normal. Medications effectively reduced reported vestibular symptoms in 88% of those treated with tricyclics (n = 8), 86% of those treated with cyprohepatadine (n = 7), 80% of those treated with topiramate (n = 5), 80% of those treated with triptans (n = 10), and 25% of those treated with gabapentin (n = 4). CONCLUSIONS: Vestibular migraine is a common cause of vertigo in the pediatric population that is frequently responsive to medical therapy. SN - 1532-2130 UR - https://www.unboundmedicine.com/medline/citation/26521123/Evaluation_and_management_of_vestibular_migraine_in_children:_Experience_from_a_pediatric_vestibular_clinic_ DB - PRIME DP - Unbound Medicine ER -