| ObjectiveThis study was conducted to compare the clinical characteristics and balance control of patients with vestibular migraine of childhood(VMC),probable vestibular migraine of childhood(pVMC),and recurrent vertigo of childhood(RVC)by means of retrospective analysis,to explore the differences in vertigo disorders in children with or without migraine,and to provide new ideas for the study of the pathogenesis of vertigo in children.MethodsClinical case data of patients with confirmed VMC,pVMC and RVC who were hospitalized in our otorhinolaryngology department from July 2018 to March 2022 were collected and retrospectively studied.Inclusion criteria:diagnosed VMC,pVMC,and RVC disorders according to the consensus document of the diagnostic criteria of the Barany Society and the Vestibular Disorders Classification Committee of the International Headache Society in 2021,with complete clinical data of Sensory Integration Test(SOT).Exclusion criteria:patients with vertigo/dizziness in combination with other diseases,such as sensorineural hearing loss,Meniere’s disease,vestibular neuritis,recurrent otitis media,intracranial lesions,metabolic disease,epileptic vertigo,other systemic diseases;incomplete patient SOT history.The collected case data included the patient’s gender,age,height,weight,body mass index(BMI),results of postural control assessment using the six conditions of SOT(equilibrium score,sensory weight analysis,balance strategy score),and vestibular function(video-head impulse test,hot and cold test,and cervical/ocular vestibular evoked myogenic potentials).The disease groups were divided into ≤12 years and 13-17 years groups according to the age of the patients.The data obtained were statistically analyzed using SPSS 26.0 software,using one-way ANOVA to compare significant differences in clinical characteristics(age,height,weight,and BMI)between the two age groups,and between the different disease groups;using χ2 test to compare and analyze significant differences in gender between the two age groups,and using multi-factor ANOVA to explore the effects of age,disease,age and disease.The effect of the interaction of age,disease,and age and disease on sensory integration and balance control in patients with VMC,pVMC,and RVC was explored using the Bonterroni test for post hoc testing,and P<0.05 represented a statistically significant difference.ResultsExcluding 17 patients who did not meet the inclusion criteria,a total of 125 patients with vertigo/dizziness in children were included in this study,including 65(52%)males and 60(48%)females,with a male to female ratio of 13:12,aged 5 to 17 years,mean age 11.30±2.62 years,including 33(26.4%)patients with VMC,18(14.4%)patients with pVMC,and 74(59.2%)patients with RVC.Among the children in the ≤12 years old group,19 patients(24.7%)were in the VMC group,10 patients(13.0%)in the pVMC group,and 48 patients(62.3%)in the RVC group;among the children in the 13-17 years old group,14 patients(29.2%)were in the VMC group,8 patients(16.6%)in the pVMC group,and 26 patients(54.2%)in the RVC group.In both age groups,there were no statistically significant differences in age,sex,height,weight,and BMI between the different disease groups(all P values>0.05).Patients in the 13-17 years old group had higher equilibrium score in all six SOT conditions than patients in the ≤12 years old group(P=0.006,P=0.000,P=0.003,P=0.005,P=0.022,P=0.000,P=0.001),and the effects of disease,age and disease interaction on equilibrium score were not significant(all P values>0.05).Patients in the 13-17 years old group had higher somatosensory ratio and visual ratio than those in the≤12 years old group(P=0.001,P=0.019),and none of the effects of disease,age and disease interaction on somatosensory ratio and visual ratio were significant(all P-values>0.05).The effects of age,disease,and the interaction of age and disease on vestibular ratio were not significant(all P values>0.05).The effect of age and disease on visual preference was not significant(all P values>0.05),but the effect of the interaction of age and disease on visual preference was significant(P=0.033).Among patients in the≤12 years old group,visual preference was significantly higher in the VMC group than in the pVMC and RVC groups(P=0.013,P=0.027);among patients in the 13-17 years old group,the differences in visual preference among the three disease groups were not statistically significant(all P values>0.05).Only in patients in the RVC group,visual preference was higher in patients aged 13-17 years than in patients in the<12 years group(P=0.015);the differences in visual preference between the different age groups were not statistically significant in patients in both the VMC and pVMC groups(all P values>0.05).The effects of age and age-disease interaction on strategy scores were not significant(all P values>0.05),and only in condition 3 of SOT the VMC group scored higher than the pVMC and RVC groups(P=0.030);in the other conditions of SOT,the differences in strategy scores between the RVC,VMC and pVMC groups were not statistically significant(all P values>0.05).In the vestibular function examination,age only had an effect on the video-head impulse test(vHIT)of the right horizontal semicircular canal(P=0.005),and the effect on the other lateral semicircular canals was not significant(all P values>0.05),and the effects of disease,age and disease interaction on vHIT were not significant(all P values>0.05).The effects of age,disease,and the interaction of age and disease on cervical vestibular evoked myogenic potentials(cVEMP),ocular vestibular evoked myogenic potentials(oVEMP),and hot and cold tests were not significant(all P values>0.05).Conclusion1.In the younger child patient(≤12 years old)group,patients in the VMC group were more dependent on vision and less able to maintain balance than patients in the pVMC and RVC groups;in the older child patient(13-17 years old)group,there was no significant difference in visual preference among patients in the VMC,pVMC,and RVC groups.2.In the RVC group,older child patients(13-17 years old)were more dependent on vision than younger child patients(≤ 12 years old).3.Sensory integration tests were able to distinguish between the VMC,pVMC and RVC disease groups,and vestibular function tests were unable to distinguish between the disease groups. |
