Pediatric emergency medicine trisk 0545 0545
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The differential diagnosis of headache and vertigo also includes a brainstem or
cerebellar mass, hemorrhage, and infarction. These uncommon disorders are best
assessed by MRI.
Benign Paroxysmal Vertigo of Childhood
Considered by many to be a form of migraine, benign paroxysmal vertigo of
childhood is most common in children between the ages of 1 and 5 years. Patients
have recurrent attacks, usually one to four per month, and occasionally in
clusters. Onset is sudden—the child often cries out at the start of each episode—
and is associated with emesis, pallor, sweating, and nystagmus. Episodes are
brief, lasting up to a few minutes, and may be mistaken for seizures.
Consciousness and hearing are preserved, and the neurologic examination is
otherwise normal. The electroencephalogram (EEG) is normal. The disorder
spontaneously remits after 2 to 3 years.
TABLE 24.2
COMMON CAUSES OF VERTIGO
Suppurative or serous labyrinthitis
Benign paroxysmal vertigo
Migraine
Vestibular neuronitis
Ingestions
Seizure
Motion sickness
