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儿童前庭性偏头痛和复发性眩晕:来自一家三级医院的研究的诊断重点。

Vestibular Migraine and Recurrent Vertigo in Children: A Diagnostic Focus From a Tertiary Hospital Study.

机构信息

College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China; Department of Neurology, Qinghe Central Hospital, Xingtai City, Hebei Province, China.

College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China; National Key Laboratory of Hearing and Balance Science, Beijing, China; National Clinical Research Center for Otolaryngologic Diseases, Beijing, China; State Key Lab of Hearing Science, Ministry of Education, Beijing, China; Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China.

出版信息

Pediatr Neurol. 2024 Sep;158:86-93. doi: 10.1016/j.pediatrneurol.2024.06.011. Epub 2024 Jun 25.

Abstract

BACKGROUND

To improve diagnostic precision in pediatric vertigo, particularly in Vestibular Migraine of Childhood (VMC), probable VMC (pVMC), Recurrent Vertigo of Childhood (RVC), and unspecified categories, by delineating clinical characteristics and prevalence to refine diagnostics and treatments.

METHODS

Retrospective analysis of 102 pediatric patients (five to 18 years; 46 females, 56 males) at the Dizziness Center of the Otolaryngology Department in a tertiary-level hospital from January 2019 to December 2023. Patients were classified into VMC, pVMC, RVC, and indeterminate groups. Evaluations included audiometry and vestibular tests (video head impulse test [vHIT] or caloric testing), conducted in the audiology unit and vestibular testing laboratory. Data were analyzed using IBM SPSS 20.0.

RESULTS

Diagnoses were 8.8% VMC, 31.4% pVMC, 51.0% RVC, and 8.8% indeterminate. Nausea and vomiting were common in VMC and pVMC; cochlear symptoms like tinnitus and hearing loss predominated in VMC. Although vestibular testing showed no significant group differences, VMC had more vHIT abnormalities and RVC had more caloric test anomalies.

CONCLUSIONS

This study highlights the need for comprehensive diagnostics in pediatric vestibular disorders, revealing unique and overlapping traits across VMC, pVMC, and RVC. Insights call for further research to refine diagnostic criteria and improve treatment methods.

摘要

背景

为了提高儿科眩晕的诊断精度,特别是在儿童偏头痛性眩晕(VMC)、可能的 VMC(pVMC)、儿童复发性眩晕(RVC)和未明确分类中,通过描绘临床特征和患病率来完善诊断和治疗。

方法

回顾性分析 2019 年 1 月至 2023 年 12 月在一家三级医院耳鼻喉科头晕中心的 102 例儿科患者(5 至 18 岁;46 名女性,56 名男性)。患者分为 VMC、pVMC、RVC 和未确定组。评估包括听力和前庭测试(视频头脉冲测试[vHIT]或温度测试),在听力学单位和前庭测试实验室进行。数据使用 IBM SPSS 20.0 进行分析。

结果

诊断为 8.8%的 VMC、31.4%的 pVMC、51.0%的 RVC 和 8.8%的不确定。恶心和呕吐在 VMC 和 pVMC 中很常见;VMC 中以耳鸣和听力损失为主的耳蜗症状更为常见。尽管前庭测试显示各组之间无显著差异,但 VMC 的 vHIT 异常更多,而 RVC 的温度测试异常更多。

结论

本研究强调了在儿科前庭疾病中进行全面诊断的必要性,揭示了 VMC、pVMC 和 RVC 之间具有独特和重叠特征。这些发现需要进一步研究以完善诊断标准并改善治疗方法。

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