Benign paroxysmal vertigo of childhood
| Benign paroxysmal vertigo of childhood | |
|---|---|
| Synonyms | BPVC |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Vertigo, nystagmus, vomiting, pallor, ataxia |
| Complications | N/A |
| Onset | Typically between ages 1 and 4 |
| Duration | Episodes last minutes to hours |
| Types | N/A |
| Causes | Unknown, possibly related to migraine |
| Risks | Family history of migraine |
| Diagnosis | Clinical evaluation, exclusion of other causes |
| Differential diagnosis | Vestibular migraine, epilepsy, ear infection |
| Prevention | N/A |
| Treatment | Reassurance, monitoring, sometimes vestibular rehabilitation |
| Medication | N/A |
| Prognosis | Generally good, often resolves by age 5 |
| Frequency | Rare |
| Deaths | N/A |
Benign Paroxysmal Vertigo of Childhood (BPVC) is a neurological disorder that affects children, characterized by sudden, brief episodes of vertigo or dizziness without loss of consciousness. These episodes are termed "paroxysmal" because they occur abruptly and last for a short duration. BPVC is considered a benign condition as it does not lead to serious complications and often resolves on its own as the child grows older.
Symptoms
The primary symptom of BPVC is sudden episodes of vertigo, where the child may feel as if they or their surroundings are spinning or moving. These episodes can lead to imbalance, unsteadiness, nausea, and vomiting. The child may also exhibit nystagmus, a condition where the eyes make repetitive, uncontrolled movements. Typically, these episodes are brief, lasting from a few seconds to several minutes, and occur without warning. Children are usually completely normal between episodes, with no lasting effects on their balance or hearing.
Causes
The exact cause of BPVC is not well understood, but it is believed to be related to the developing nervous system of children. Some theories suggest a connection to migraines, as children with BPVC may have a personal or family history of migraines. This has led researchers to speculate that similar pathophysiological mechanisms may underlie both conditions.
Diagnosis
Diagnosing BPVC involves a thorough medical history and physical examination. Since there are no specific tests for BPVC, the diagnosis is primarily clinical, based on the characteristic symptoms and the exclusion of other conditions that could cause similar symptoms, such as ear infections, epilepsy, or more serious neurological disorders. A key diagnostic criterion is the absence of neurological deficits or hearing loss in between episodes.
Treatment
Treatment for BPVC is generally supportive, focusing on managing symptoms and reassuring the child and family. Medications are not typically used, but in cases where BPVC is associated with migraines, migraine-preventive treatments may be considered. Education about the condition and reassurance that the episodes will likely decrease in frequency and eventually stop as the child grows older are important aspects of management.
Prognosis
The prognosis for children with BPVC is excellent. Most children outgrow the condition by adolescence, with no lasting effects on their balance or neurological health. However, some children with BPVC may develop migraines later in life, suggesting a potential link between the two conditions.
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Contributors: Prab R. Tumpati, MD