A case of benign paroxysmal vertigo during childhood transitioning into atypical basilar migraine that was effectively treated using lomerizine

Abstract

We report a case of benign paroxysmal vertigo during childhood (BPV) transitioning into atypical basilar migraine (BM) that was effectively treated using lomerizine. A 6-year-old boy visited our hospital complaining of repeated attacks of vertigo for 3 months. His vertigo attacks lasted a few hours and were accompanied by nausea, vomiting, intense fear, and a loss of consciousness. Nystagmus was not observed during the vertigo attacks. Blood tests and imaging examinations showed no abnormal findings. The results of electronystagmography and a caloric test were unremarkable. Pure-tone audiometry showed a profound right-side sensorineural hearing loss. Among the differential diagnoses, delayed endolymphatic hydrops, epilepsy, and BM were considered. Delayed endolymphatic hydrops was considered unlikely because nystagmus had not occurred during the vertigo attacks and there was no change in hearing: electroencephalography showed no epileptic seizure waves. His vertigo attacks are currently well controlled with lomerizine. Although no obvious headaches accompanied the vertigo attacks, this case was diagnosed as atypical BM because the use of lomerizine, an agent for the treatment of migraine, was effective. Since BPV is reportedly closely related to migraine and because the start of the vertigo attacks was accompanied by the loss of consciousness, we suspect that this patient had atypical BM transitioning from BPV. Our experience in treating this patient showed that lomerizine was effective for the treatment of migrainous vertigo during childhood.