Basilar Migraine of Childhood; A Case Report.

Many reports of migraine-associated vertigo from Western countries can be found in the literature. However, this condition is rarely reported in Japan, probably because of the lower incidence of migraines in comparison to the West. We report here the case of a ten year-old boy who had experienced recurring attacks of vertigo with severe headaches for seven years. There were no obvious neurological symptoms or aural symptoms. Sensorineural hearing loss and canal paresis of the left ear were revealed by pure tone audiometry and caloric testing. Auditory brainstem response testing demonstrated an elongation of the I -V interpeak latency on the left, although his electrocochleogram was normal. Brain MRI, MR angiography and temporal bone high resolution CT scanning all revealed no organic lesions. His EEG was also normal. Placebo, Tofisopam and Carbamazepine were administered successively to rule out psychogenic vertigo and epilepsy, respectively, but were not effective. In contrast, Adenosine Triphosphate Disodium was somewhat effective, and Dihydroergotamine Mesylate was remarkably effective. We concluded that the vertigo was probably due to a basilar migraine, with frequent vertebrobasilar ischemia during the migraine attack, which caused the left inner ear and eighth cranial nerve lesions.