21 children suffering from benign paroxysmal vertigo (BPV) were submitted to complete otoneurological examination, including caloric and rotational tabyrinthine stimulation with ENG recording, and to headache provocation tests with nitroglycerin, histamine and fenfluramine. Vestibular responses were normal in all except 2 cases which presented signs of central vestibular impairment at the level of the vestibulo-cerebellar pathways. Headache provocation tests were positive in 10 out of 15 children, and in 5 cases they induced a typical vertiginous attack instead of headache.
Several children had a positive family history for migraine. Sometimes headache was associated with the vertigo attack. Sometimes other signs of a “periodic syndrome” (motion sickness, cyclic vomiting, abdominal pain) occurred at times which were unrelated to vertiginous attacks. During the follow-up period, some children responded positively to migraine treatment.
By the authors, BPV is considered a migraine equivalent or a migraine precursor, and could be due to the same pathogenetic mechanisms responsible for the migraine.