title: Benign paroxysmal vertigo of childhood.
abstract: OBJECTIVE
  To relate the authors' experience to the diagnosis and follow-up of patients with benign paroxysmal vertigo of childhood (BPV) who were followed-up at the Children's Hospital of Bydgoszcz between 1999 and 2004, and to review and discuss controversial issues regarding the disease.
  
  
  METHODS
  Among 124 children suffering from vertigo 14 were classified as having BPV. All the children were submitted to differential diagnosis protocol which consisted of meticulous history, otolaryngological, ophthalmological, psychological, neurological examination, biochemical tests and standard neurootological examination including caloric tests. The children were followed-up and the tests were repeated if no improvement was observed.
  
  
  RESULTS
  All the children suffered from episodic vertigo of variable intensity and frequency. All of them were neurologically intact. In 8 patients pathologic ENG results were found, only 1 patient with canal paresis could be considered as having peripheral lesion, 7 patients had central/mixed pathology. The follow-up was favorable in majority of patients. Six of them recovered completely, in 6 an improvement was noted and in 2 no improvement was observed. Three patients after remission of BPV attacks developed migraine. One child before development of BPV attacks suffered from paroxysmal torticollis of infancy.
  
  
  CONCLUSIONS
  Childhood BPV is a disorder of vestibular system with the onset occurring mainly in preschoolers aged 1-7. Older children with the onset of BPV - like symptoms should be suspected for functional background of the disease. There are no typical ENG features for BPV. The only objective evidence of vestibular dysfunction is the presence of nystagmus during the attack. The disease is probably of vascular origin and there is strong evidence for close relationship between spasmodic torticollis, BPV and migraine.
authors.affiliation: Department of Pediatric Otolaryngology, Children's Hospital of Bydgoszcz, Poland.
authors.forename: Józef
authors.initials: J
authors.lastname: Mierzwiński
authors.forename: Maciej
authors.initials: M
authors.lastname: Polak
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Dalke
authors.forename: Paweł
authors.initials: P
authors.lastname: Burduk
authors.forename: Henryk
authors.initials: H
authors.lastname: Kaźmierczak
authors.forename: Marek
authors.initials: M
authors.lastname: Modrzyński
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004244:Dizziness / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis; D008881:Migraine Disorders / Q000175:diagnosis / Q000209:etiology; D009759:Nystagmus, Pathologic / Q000150:complications / Q000175:diagnosis*; D011187:Posture; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014103:Torticollis / Q000209:etiology / Q000503:physiopathology; D014717:Vertigo / Q000175:diagnosis* / Q000503:physiopathology*; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000503:physiopathology*