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Migraine and the vestibular system in childhood and adolescence.

A review of the literature gives considerable evidence that there are manifestations of migraine involving the vestibular system starting in infancy and proceeding to late life. This paper deals with these manifestations in the first two decades of life. There is evidence that vestibular symptoms are probably caused by involvement at different levels of the system in different cases. Paroxysmal vestibular symptoms may occur in association with headache, temporally independent of headache, or without headache, and may at times be the chief complaint causing the patient to seek help from the otolaryngologist in the latter two instances. Other neurologic symptoms may or may not be present. Meticulous family, past personal, and present history are the sources of information necessary to suspect the association of paroxysmal vestibular symptoms and a migraine diathesis. A prospective study of a large neurotologic population of this age group with recurrent paroxysmal vestibular symptoms seems indicated and may lead to diagnostic and therapeutic benefits.