Benign Vertigo of Childhood (BVC)

What are the signs and symptoms of BVC?

• Short episodes of dizziness (seconds to minutes) that start and resolve spontaneously
• During an episode, your child may seem fearful and may not be able to describe what’s happening (children who are too young to explain how they feel may cling to a caregiver’s leg until the feeling passes)
• Paleness or sweating
• Loss of balance or difficulty walking
• Motion sickness, sometimes with vomiting
• Nystagmus (fluttering eye movements)

BVC does not usually cause loss of consciousness and ear-related symptoms such as decreased hearing, tinnitus or pressure. The episodes are random and are not brought on by position changes or movements.

What tests are used to diagnose BVC?

There is no single test to diagnose BVC. At Children’s Hospital Colorado, we’ve created the Pediatric Balance and Vestibular Disorders Clinic to help diagnose and treat conditions like BVC. Our neurologists, otolaryngologists (ENT, or ear, nose and throat doctors) and audiologists work together on a comprehensive evaluation of your child that includes:

• Neurologic evaluation
• Imaging tests such as a CT scan or MRI
• Vestibular testing to rule out other causes of dizziness
• Physical therapy evaluation
• Hearing test

It’s helpful to keep a journal of your child’s BVC episodes with details that can help us make a diagnosis, including:

• Time and length of episodes
• Symptoms
• Events that may have triggered an episode

We follow diagnostic criteria formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The criteria to diagnose benign vertigo of childhood are:

• At least 5 episodes of severe vertigo that happen without warning and resolve on their own in minutes to hours
• Normal neurologic examination, audiometric, and vestibular functions between attacks
• A normal electroencephalogram

What can I expect during a BVC evaluation?

The first step is a vestibular evaluation, which may require a referral to our Audiology Services from your child’s doctor. This evaluation takes either 1.5 hours or 2.5 hours, depending on your child’s age and developmental level.

Depending on the evaluation results, your child may be referred to the Pediatric Balance and Vestibular Disorders Clinic for a multidisciplinary exam by doctors from Otolaryngology (ENT), Audiology, Physical Therapy and Neurology. If your child already has a managing neurologist, we may refer you back to that provider for BVC diagnosis and treatment instead of the balance and vestibular clinic.

How is BVC treated?

While there is currently no recommended medical treatment for BVC, we can offer recommendations on how to comfort your child during episodes. BVC may be frightening to your child, but it is not life-threatening.

BVC is often associated with vestibular migraines. Children with vestibular migraines can reduce the number and intensity of migraines by developing healthy habits. These healthy habits may also reduce the number of BVC episodes your child experiences:

• Maintaining a regular sleep and meal schedule
• Eating whole, nutritious foods rather than processed foods
• Staying hydrated throughout the day
• Avoiding triggers
• Exercising regularly
• Managing stress and anxiety

Why choose us for treatment of BVC?

The Pediatric Balance and Vestibular Disorders Clinic (PBVDC) at Children’s Colorado specializes in conditions like benign vertigo of childhood. When children complain of imbalance or dizziness, it could be the result of many different conditions. Our dedicated clinic helps diagnose and treat the full range of conditions related to these signs and symptoms.

Children’s Colorado is the only center in the state that has an enclosed rotary chair, which is necessary for assessing vestibular disorders in children with developmental differences. Without this testing, it is difficult to completely rule out inner ear disorders as the cause of dizziness.

Contacting us and making an appointment

If your child is experiencing dizziness, talk to their doctor or neurologist about your concerns. We usually require a referral to both audiology and ENT departments by a physician or advanced practice provider for vestibular testing and diagnostic exams.

We also want to ensure that your child does not need urgent medical attention. You can discuss your child’s symptoms with an ENT nurse and get advice by calling 720-777-8501.

Most of the time, we recommend vestibular testing to gather more information. If a vestibular evaluation is recommended, a scheduler will contact you to set up an appointment and provide additional instructions on how to prepare for the evaluation.