Characteristics of vestibular migraine, probable vestibular migraine, and recurrent vertigo of childhood in caloric and video head impulse tests

Qin Zhang; Qiong Wu; Jianyong Chen; Xueyan Wang; Yuzhong Zhang; Shuyun Liu; Lu Wang; Jiali Shen; Min Shen; Xinyi Tang; Ling Mei; Xiangping Chen; Yulian Jin; Jun Yang; Qing Zhang

doi:10.3389/fneur.2022.1050282

Characteristics of vestibular migraine, probable vestibular migraine, and recurrent vertigo of childhood in caloric and video head impulse tests

Front Neurol. 2022 Nov 30:13:1050282. doi: 10.3389/fneur.2022.1050282. eCollection 2022.

Authors

Qin Zhang^{1

2

3}, Qiong Wu^{1

2

3}, Jianyong Chen^{1

2

3}, Xueyan Wang⁴, Yuzhong Zhang⁵, Shuyun Liu⁶, Lu Wang^{1

2

3}, Jiali Shen^{1

2

3}, Min Shen^{1

2

3}, Xinyi Tang^{1

2

3}, Ling Mei^{1

2

3}, Xiangping Chen^{1

2

3}, Yulian Jin^{1

2

3}, Jun Yang^{1

2

3}, Qing Zhang^{1

2

3}

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
² Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.
³ Shanghai Key Laboratory of Translational Medicine in Ear and Nose Diseases, Shanghai, China.
⁴ Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, Jilin, China.
⁵ Department of Otolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China.
⁶ Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

Abstract

Objective: Vertigo is very common in children, but the specific diagnosis and characteristics are not clear. The main objective of this study was to analyze the characteristics of caloric test (CT) and video head impulse test (vHIT) in vestibular migraine of childhood (VMC), probable vestibular migraine of childhood (PVMC), and recurrent vertigo of childhood (RVC), which can provide a reference value for their clinical diagnosis.

Methods: We selected VMC, PVMC and RVC patients under 18 years of age from the outpatient Department of Otolaryngology-Head and Neck Surgery between May 2021 and August 2022. All patients underwent vestibular function examinations, including eye movement recording CT and vHIT. CT results depended on whether both canal paresis and directional preponderance were under normal limits, and vHIT results depended on the gain values of vestibulo-ocular reflex. The results of both tests were analyzed according to the disease type.

Results: Among the 81 pediatric vertigo patients aged 5-17 years, 44 were females and 37 were males. According to the type of vertigo, 29 patients (25.80%) were diagnosed with VMC, 11 (13.58%) with PVMC, and 41 (50.62%) with RVC. The abnormal rates of the CT in VMC, PVMC, and RVC patients were 24.14%, 36.36%, and 17.07%, respectively. There was no significant difference in the abnormal rates among the three groups (P > 0.05). None of the patients showed abnormal vHIT results (all abnormal rates 0.00%). The abnormal CT rates were significantly higher than those of abnormal vHIT rates (P < 0.05).

Conclusions: VMC, PVMC, and RVC are more likely to be diagnosed by symptoms, as neither CT nor vHIT are specific to any conditions. Due to different clinical presentations of vertigo in pediatric patients, it is critical to further clarify the diagnosis with medical history and clinical characteristics.

Keywords: caloric test; child; symptoms; vertigo; vestibular migraine; video head impulse test.