Recurrent Vertigo of Childhood Revisited: Evidence for a Developmental Vestibular Migraine Spectrum
Abstract
Background: : Vertigo and dizziness are common neurological complaints in childhood, and increasing evidence suggests that a substantial proportion of recurrent vestibular symptoms may represent early manifestations of migraine-related disorders. However, current diagnostic criteria for pediatric vestibular migraine may underestimate migraine involvement in prepubertal children, in whom vestibular and autonomic symptoms often precede or occur independently of headache.
Objectives:: To reassess a large pediatric cohort of children with recurrent vestibular symptoms using a developmental migraine-spectrum model integrating vestibular manifestations, migraine precursors, and susceptibility markers.
Methods:: This retrospective multicenter study analyzed 146 children aged 3-12 years evaluated for recurrent vestibular symptoms between 1995 and 2022 at two Italian tertiary referral centers. All patients were initially classified according to the 2021 Bárány Society and International Headache Society criteria. A secondary structured evaluation assessed family history of migraine, headache characteristics, vestibular phenotype, benign paroxysmal torticollis, extra-vestibular migraine precursors (cyclic vomiting, recurrent abdominal pain, and related episodic syndromes), and migraine susceptibility markers including motion sickness and sensory hypersensitivity.
Results:: Of the 146 children, 144 fulfilled the Bárány Society criteria for Recurrent Vertigo of Childhood, whereas two…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 146 participants or records.
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