Benign paroxysmal vertigo of childhood

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Benign paroxysmal vertigo of childhood
Classification and external resources

Benign paroxysmal vertigo of childhood causes paroxysmal vertigo; which is the feeling that the world around the person is spinning, or the spinning is happening inside the person's head
ICD-10 G43.821

Benign paroxysmal vertigo of childhood (BPVC for short) (this means harmless dizziness, that happens again and again and happens suddenly) is a medical condition which occurs in children usually starting between two and five years of age; it often disappears by the age of eight. But BPVC can start as young as a few months old to as late as 12-years-old. It causes a kind of dizziness called paroxysmal vertigo. With this kind of vertigo people feel that they are moving or spinning or that the inside of their head is moving or spinning.

Some doctors think that paroxysmal vertigo is related to problems of the inner ear that affect balance.[1] Doctors don't know for sure what causes BPVC. BPVC is the most common cause of dizziness in children who do not have hearing loss or a diagnosed ear disease. It is a common disorder that happens to about 2.6% of children some experts consider it to be a precursor to migraine headache. (Abu-Arufeh and Russell, 1995).

Causes[change | edit source]

Some doctors believe BPVC is similar to a kind of disorder often found in adults over 50 called benign paroxysmal positional vertigo (BPPV), which is a kind of vestibular disorder',' a disorder in the inner ear which affects balance. Other doctors feel it is related to migraine headaches, but headaches usually do not happen when a child has BPVC.[2]

Signs and symptoms[change | edit source]

This shows what the inner ear looks like, the vestibular system is the colored part. The inner ear is the part of the ear that is inside a person's head.
This shows what the inner ear looks like, the vestibular system is the colored part. The inner ear is the part of the ear that is inside a person's head.
This is the part of the inner ear called the vestibular system. Some doctors think a problem here may cause Benign paroxysmal vertigo of childhood.
This is the part of the inner ear called the vestibular system. Some doctors think a problem here may cause Benign paroxysmal vertigo of childhood.
Horizontal (side to side) optokinetic nystagmus. The eyes may also move up and down (vertical optokinetic nystagmus).
Nystagmus: sometimes called "dancing eyes" is fast, uncontrollable movements of the eyes. This eye movement may occur on its own or be caused by staring. When not having other symptoms the child may have positional nystagmus which happens when the head is in a certain position.
Nausea: this is when a person feels sick in their stomach and may feel like vomiting.
Vomiting: this is when a person begins "throwing up".
Gait ataxia: this is when a medical condition (like BPVC) makes the muscles not work together (coordination), this causes a person to have problems walking. This symptom may be harder to see in infants who are not yet walking.
Postural imbalance: this is when a person finds it hard keeping their balance so it makes it hard to stand up straight. This symptom may be harder to see in infants who are not yet standing.
Fearful expression: this is when the child looks scared. They usually look scared because of the physical symptoms that BPVC is causing like the loss of balance and the dizziness.

Diagnosis[change | edit source]

For a diagnosis of Benign paroxysmal vertigo of childhood to be made the child has to have:

  • at least five attacks.
  • get vertigo (dizziness) a lot, that happen all of a sudden, and go away after a few minutes to a few hours.
  • a normal neurologic examination: tests to make sure there is no problem in the brain
  • normal audiometric and vestibular functions between attacks: there is no problem that can be found in the inner ear (inside part of the ears).
  • normal Electroencephalography (EEG): a person's brain makes small amounts of electricity and this tests makes sure that this is working good.

Adapted from:The Headache Classification Subcommittee of the International Headache Society, 2004[3].

Differential diagnoses[change | edit source]

Differential diagnoses are different medical disorders which may cause the same symptoms. Before a doctor makes a final diagnosis, which means they are sure of what medical disorder is causing the problem, they think of what other medical conditions have the same or almost the same symptoms, and make sure it's not one of them.[4]

Some of the differential diagnoses of Benign paroxysmal vertigo of childhood are:

  • posterior fossa tumors: this a tumor in the part of the brain in or near the bottom of the skull. Posterior fossa tumors happen more in children than they do in adults. About 54%-70% of all brain tumors that children get start in the posterior fossa.
  • cervical spine abnormalities: these are problems with the part of the spine in the neck.
  • otological disorders: these are problems in the inside part of ears.
  • epilepsy (benign occipital epilepsy): this is a kind of brain disorder.
  • metabolic disorders: this is when there is a problem with the way the body makes energy from food.

References[change | edit source]

  1. Thomas Brand: Vertigo: Its Multisensory Syndromes p.336 (Springer) 2003
  2. Michael C. Brodsk: Pediatric Neuro-Ophthalmology p.218 (Springer, 2010)
  3. The Headache Classification Subcommittee of the International Headache Society, 2004 [1]
  4. "Differential diagnosis". Free Merriam-Webster Dictionary. 2012. http://www.merriam-webster.com/dictionary/differential%20diagnosis. Retrieved November 8, 2012.