Pediatric Benign Paroxysmal Positional Vertigo and Migraine Development

Introduction: Benign paroxysmal positional vertigo (BPPV) is uncommon in the pediatric population; however, it is frequently observed that patients diagnosed with BPPV as children can develop migraine symptoms later in life. We aim to explore the relationship between pediatric BPPV and subsequent migraine development.

Methods: Patients ages 1 to 17 (pediatric cohort) with and without a diagnosis of BPPV were queried on the TriNetX research database from 2000-2023. Subgroups of pediatric patients ages 1-8 (prepubescent) and 9-17 (pubescent) were also queried. Exclusion criteria included a diagnosis of migraine prior to BPPV, history of developmental disorder, and head trauma. Cohorts were propensity-score matched by age at index, sex, race, BMI, nervous system diseases, and neuropsychiatric disorders. Diagnosis of migraine up to 10 years after BPPV diagnosis was compared between the groups.

Results: From the database, 1,378; 242; and 1,135 patients in the pediatric, pre-pubescent, and pubescent cohorts were diagnosed with BPPV, respectively. Comparatively, 6,539,114; 2,567,802; and 3,971,312 patients in the pediatric, prepubescent, and pubescent cohorts did not have a BPPV diagnosis, respectively. Within the entire pediatric population (ages 1-17), patients with BPPV diagnosis were more likely to develop migraine (OR = 8.769, p < 0.001). Patients in the pubescent sub-group with BPPV were also more likely to be later diagnosed with migraines (OR = 6.363, p < 0.001). A sum of 14 patients in the prepubescent cohort with BPPV developed migraine, while no patients without prior BPPV developed migraine.

Conclusions: Pediatric patients with a diagnosis of BPPV had a higher incidence of developing migraines later in life. There is an association between pediatric BPPV and subsequent migraine development during adulthood.