Faralli Mario, Lupinelli Giacomo, Orzan Eva, Verrotti Alberto, Ricci Giampietro, Gambacorta Valeria
Section of Otorhinolaryngology, Department of Medicine and Surgery University of Perugia, Perugia, Italy.
Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137, Trieste, Italy.
Int J Pediatr Otorhinolaryngol. 2025 Jun;193:112331. doi: 10.1016/j.ijporl.2025.112331. Epub 2025 Apr 2.
Migraine is the most common etiology of episodic vertigo in pediatric populations. The characteristics of migraine headaches in children differ from those in adults, with initial manifestations frequently presenting as periodic syndromes. Sleep disorders are prevalent among individuals with migraines. Headaches may not be present in early childhood, and children may not easily report aura or phono-photophobia. Therefore, it is essential to identify clinical and anamnesic elements that can support the etiopathogenetic hypothesis of migraine in the assessment of episodic idiopathic vertigo. The objective of this study was to assess the validity of research concerning sleep disorders in children experiencing episodic vertigo, with the aim of providing evidence for a connection to migraine.
The study included 25 participants diagnosed with episodic idiopathic vertigo, including 13 females and 12 males, aged between 5 and 14 years. A range of anamnestic parameters was analyzed, including the presence, type, and age of onset of sleep disorders; the presence, characteristics, and age of onset of headaches; and the presence of a family history of migraine. The data were compared with those of a control group matched for age and sex, which was affected by dysfunctional dysphonia and had no history of vertigo. The comparison of percentage values concerning the parameters under examination was conducted using the chi-square statistic test with Yates correction. A t-test was employed to compare the means and standard deviations. The significance limit is established for p values ≤ 0.05.
Sleep disorders were present in 15 out of 25 patients (60 %) with episodic vertigo, compared to 3 out of 25 (12 %) in the control group (p = 0.001). Somniloquy is the most prevalent disorder. Headache was reported by 12 out of 25 recruited patients (48 %), with 8 cases classified as migraine-type, 1 as tension-type, and 3 as mixed or indefinite-type. In the control group, 4 out of 25 (16 %) reported headaches, including 1 migraine-type, 2 tension-type, and 1 mixed or indefinite-type (p = 0.03). A family history of migraine was identified in 19 (76 %) of the 25 patients and in 7 (28 %) of the 25 subjects in the control group (p = 0.001). The average age of onset for sleep disorders was 6.28 ± 1.67 years, while for headaches it was 9.25 ± 3.01 years (p = 0.01). The comparative analysis of symptom distribution by patient age indicates that all patients with sleep disorders reported this clinical manifestation by the age of eight years. Conversely, only 26.6 % of these patients reported experiencing the headache for the first time at the same age.
Children with episodic idiopathic vertigo exhibit a high prevalence of sleep disorders, alongside a significant correlation with headaches and a familial history of migraine. In younger patients, migraine symptoms, particularly headache, necessary for diagnosing vestibular migraine, are frequently absent or unreported. Studies on sleep disorders in children experiencing episodic idiopathic vertigo indicate a correlation with migraine.
偏头痛是儿童发作性眩晕最常见的病因。儿童偏头痛性头痛的特征与成人不同，其初始表现常为周期性综合征。睡眠障碍在偏头痛患者中很常见。幼儿期可能不存在头痛，且儿童可能不容易报告先兆或畏声畏光症状。因此，在评估发作性特发性眩晕时，识别能够支持偏头痛病因学假说的临床和既往史要素至关重要。本研究的目的是评估有关发作性眩晕儿童睡眠障碍研究的有效性，旨在为其与偏头痛的关联提供证据。
该研究纳入了25例诊断为发作性特发性眩晕的参与者，其中13名女性和12名男性，年龄在5至14岁之间。分析了一系列既往史参数，包括睡眠障碍的存在情况、类型和发病年龄；头痛的存在情况、特征和发病年龄；以及偏头痛家族史。将这些数据与年龄和性别匹配的对照组数据进行比较，该对照组受功能性发声障碍影响且无眩晕病史。使用带有耶茨校正的卡方统计检验对所检查参数的百分比值进行比较。采用t检验比较均值和标准差。显著性界限设定为p值≤0.05。
25例发作性眩晕患者中有15例（60%）存在睡眠障碍，而对照组25例中有3例（12%）存在睡眠障碍（p = 0.001）。说梦话是最常见的障碍。25例招募患者中有12例（48%）报告有头痛，其中8例为偏头痛型，1例为紧张型，3例为混合型或不确定型。对照组25例中有4例（16%）报告有头痛，包括1例偏头痛型，2例紧张型，1例混合型或不确定型（p = 0.03）。25例患者中有19例（76%）有偏头痛家族史，对照组25例中有7例（28%）有偏头痛家族史（p = 0.001）。睡眠障碍的平均发病年龄为6.28±1.67岁，而头痛的平均发病年龄为9.25±3.01岁（p = 0.01）。按患者年龄对症状分布进行的比较分析表明，所有有睡眠障碍的患者在8岁时均报告了这种临床表现。相反，这些患者中只有26.6%在同一年龄首次报告有头痛。
发作性特发性眩晕儿童睡眠障碍患病率高，且与头痛和偏头痛家族史显著相关。在较年轻的患者中，诊断前庭性偏头痛所需的偏头痛症状，尤其是头痛，常常不存在或未被报告。对发作性特发性眩晕儿童睡眠障碍的研究表明其与偏头痛有关。
