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Answer 2
  1. BPV of childhood. This child’s recurrent attacks of vertigo relieved by sleep and vomiting most likely represent BPV of childhood.3 It commonly affects infants and preschoolers and may be a migraine variant, but there is usually no headache. About 1 in 5 children will later develop migraines, and about 2 in 5 have a family history of migraine. The outcome is benign, with resolution of attacks over months to years. The time course of symptoms in this child is not consistent with ependymoma or brainstem encephalitis. Frontal lobe seizures (when not convulsive) are characterized by brief episodes of posturing, spinning, or strange behaviors that occur in clusters, especially at night. Benign paroxysmal positional vertigo occurs in adults and involves the dislodging of otoliths in the vestibular apparatus.

     Al-Twaijri WA, Shevell MI. Pediatric migraine equivalents: occurrence and clinical features in practice. Pediatr Neurol 2002;26:365-8.

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