Evaluating children with vestibular migraine through vestibular test battery: A cross-sectional investigation

Abstract

ObjectiveThe present study aimed to investigate the status of vestibular function in children with vestibular migraine of childhood (VMC) reflected by vestibular function test battery and explore the pathophysiological implication of these instrument-based findings.MethodsThe clinical data of 22 children (mean age 10.7 ± 2.9 years) with VMC who met the diagnostic criteria of the Barany Society were collected from September 2021 to March 2022. A vestibular function test battery on these children included a caloric test, video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular vestibular-evoked myogenic potential (oVEMP); these parameters were triggered by air-conducted sound (ACS) and galvanic vestibular stimulation (GVS). The subjects were further divided into two groups: <3 months and >3 months according to the disease duration from symptom onset. The functional abnormalities and their characteristics reflected by the vestibular test battery, as well as the outcomes in children with or without aura, were analyzed.Results(1) The abnormal rate of the caloric test was 15.8% and that of vHIT was 0%. The response rates of ACS-cVEMP and ACS-oVEMP were 100% and 90.5%, respectively. The response rates of GVS-cVEMP and GVS-oVEMP were 100% and 88.9%, respectively. (2) No statistical difference was observed in the abnormal rate of the caloric test (P = 0.55) and the response rate of ACS-oVEMP (P = 0.21) between the two groups, irrespective of the course duration. (3) No statistical difference was detected in the abnormal rate of the caloric test (P = 0.53) and the response rate of ACS-oVEMP (P = 1.00) in children with or without aura.ConclusionVestibular function status comprehensively reported by the vestibular test battery did not show an aggravation with the disease duration in children with VMC. Also, it was not affected by the existence of aura in children with VMC. The high abnormal rates of the caloric test and oVEMPs (ACS-oVEMP and GVS-oVEMP) suggested that the lateral semicircular canal (low-frequency function component), the utricle, and the superior vestibular conduction pathway might be involved in VMC.

Phenotypes, bedside examination, and video head impulse test in vestibular migraine of childhood compared with probable vestibular migraine and recurrent vertigo in childhood

“…The age of onset of vertigo in our sample of VMC was 15.6 years (range 11-17), which is later than onset of probable VMC and RVC, although another study reported that the age of onset was 10.7 years in a sample of 22 subjects (16). Our data are not different from those of other investigations reporting the onset of vertigo in a sample of subjects around 14 years in which comorbidity for migraine was not assessed (17).…”

Migraña vestibular en la infancia. Una actualización

“…En un estudio retrospectivo realizado en niños diagnosticados de migraña vestibular, migraña vestibular probable y vértigo recurrente de la infancia según los criterios de la Sociedad Bárány, tanto la tomografía computarizada cerebral como el vHIT, no demostraron ningún hallazgo relevante en estos pacientes [20]. Zhang et al en 2022, no encontraron diferencias significativas en los resultados de pruebas vestibulares (pruebas calóricas, vHIT y VEMP) en niños diagnosticados de migraña vestibular de forma exclusiva [21]. En otro estudio de niños diagnosticados con migraña vestibular o sus equivalentes, no se encontraron diferencias en parámetros audiométricos ni vestibulares evaluados [22].…”

Cluster and network analysis of non-headache symptoms in migraine patients reveals distinct subgroups based on onset age and vestibular-cochlear symptom interconnection

“…A recent study examined age-related characteristics in the onset of vestibular migraines and discovered that external spontaneous vertigo and visually-induced vertigo are distinguishing clinical features of juvenile forms (45). Another study investigating vestibular migraine in children revealed high rates of abnormalities in vestibular test, suggesting the involvement of the lateral semicircular canal, the utricle, and the superior vestibular conduction pathway in vestibular migraine of childhood (46), indicating peripheral vestibular dysfunction may contribute to the manifestation of vestibular symptoms.…”