重新审视儿童复发性眩晕：支持发育性前庭性偏头痛谱系的临床发现

文献信息

中文摘要

背景： 儿童期眩晕和头晕的主诉常见，并可能与偏头痛相关特征共存。本研究在扩展的表型框架内重新评估了一个历史性儿科队列。
方法： 这项回顾性多中心描述性研究分析了1995年至2022年间在意大利两家三级神经耳科转诊中心因复发性前庭症状接受评估的146名3至12岁儿童。临床病史和神经耳科检查是共同的诊断基础，而适合年龄的听力学评估几乎在所有儿童中均进行了，额外的前庭或影像学检查则根据临床情况选择性进行。
结果： 在146名儿童中，144名符合2021年Bárány学会儿童复发性眩晕（RVC）标准，而2名表现为孤立性良性阵发性斜颈。无人符合儿童前庭性偏头痛或可能儿童前庭性偏头痛的标准。15.8%的患者报告头痛，而运动敏感、感觉过敏、自主神经症状及其他偏头痛相关的发育性综合征则频繁观察到。
结论： 在这一经过选择的转诊队列中，偏头痛相关特征的聚集与发育性偏头痛相关前庭谱系相符。这些表型关联并不能证明纵向疾病演变，需要前瞻性纵向研究。

英文摘要

BACKGROUND: Complaints of vertigo and dizziness are frequently encountered in childhood and may coexist with migraine-associated features. The present study reassessed a historical pediatric cohort within an expanded phenotypic framework.
METHODS: This retrospective multicenter descriptive study analyzed 146 children aged 3-12 years evaluated for recurrent vestibular symptoms between 1995 and 2022 at two Italian tertiary neuro-otological referral centers. Clinical history and neuro-otological examination represented the common diagnostic foundation, while age-appropriate audiological evaluation was performed in virtually all children and additional vestibular or imaging investigations were clinically selective.
RESULTS: Of the 146 children, 144 fulfilled the 2021 Bárány Society criteria for Recurrent Vertigo of Childhood (RVC), whereas two presented with isolated benign paroxysmal torticollis. None fulfilled the criteria for Vestibular Migraine of Childhood or probable Vestibular Migraine of Childhood. Headache was reported in 15.8% of patients, whereas motion sensitivity, sensory hypersensitivity, autonomic symptoms, and additional migraine-associated developmental syndromes were frequently observed.
CONCLUSIONS: In this selected tertiary cohort, the clustering of migraine-associated features was compatible with a developmental migraine-related vestibular spectrum. These phenotypic associations do not demonstrate longitudinal disease evolution, and prospective longitudinal studies are required.