1.6.2 Benign paroxysmal vertigo

Description:
A disorder characterized by recurrent brief attacks of vertigo, occurring without warning and resolving spontaneously, in otherwise healthy children.

Diagnostic criteria:
A. At least five attacks fulfilling criteria B and C
B. Vertigo1 occurring without warning, maximal at onset and resolving spontaneously after minutes to hours without loss of consciousness
C. At least one of the following associated symptoms or signs:

    1. nystagmus
    2. ataxia
    3. vomiting
    4. pallor
    5. fearfulness

D. Normal neurological examination and audiometric and vestibular functions between attacks
E. Not attributed to another disorder.

Note:
1. Young children with vertigo may not be able to describe vertiginous symptoms. Parental observation of episodic periods of unsteadiness may be interpreted as vertigo in young children.

Comments:
Posterior fossa tumours, seizures and vestibular disorders must be excluded.

The relationship between 1.6.2 Benign paroxysmal vertigo and A1.6.6 Vestibular migraine (see Appendix) needs to be further examined.