Introduction: Vertigo and dizziness are most bothersome in disorders causing chronic or recurrent complaints. Migraine related vertigo is one of the most frequent causes of vertigo and dizziness in childhood and adolescence. Pediatric neurologists need to be familiarized also with the rare diagnosis, which might be missed by general pediatricians.
Methods: A retrospective analysis on 132 patient with chronic (>3 month) and recurrent (> 3 attacks) vertigo/dizziness who presented to a referral vertigo center in a 1,5 year period (demographics, medical history, neuroophthalmological and neurological findings, vestibular testing, diagnosis).
Results: Mean age of patients was 12,7 ± 2 years (range 1,4 - 18,8 years, 60% female). Most frequent diagnosis was migraine (33%), followed by somatoform vertigo (24%) and peripheral vertigo (benign paroxysmal positioning vertigo, unilateral or bilateral failure, Ménière´s disease; 16%). Less frequent diagnoses were cerebellar ataxia (6%), orthostatic dysregulation (6%) and vestibular paroxysmia (5%). Headache was present in 60% of all patients and in76% with migraine related vertigo. Rotational vertigo was described by 51%. Permanent dizziness was complained in 24%. Vertigo or dizziness in patients with migraine last less than 1 hour in 54% of attacks.
Conclusion: Migraine is the most common cause of recurrent vertigo and dizziness in childhood and adolescence. Somatoform vertigo ranks second, followed by different forms of peripheral vertigo. Headache is the most prevalent accompanying symptom. An accurate medical history taking and careful physical examination are most relevant to make the correct diagnosis.