BPPVi

BPPVi, or Benign Paroxysmal Positional Vertigo of Infancy, is a common, self-limiting condition characterized by recurrent episodes of vertigo or dizziness in infants and young children. It is considered the pediatric equivalent of BPPV (Benign Paroxysmal Positional Vertigo) in adults, though the underlying mechanisms may differ. The hallmark of BPPVi is the sudden onset of unsteadiness, often accompanied by nystagmus (involuntary eye movements) and sometimes vomiting, triggered by specific changes in head position. These positional changes typically involve tilting the head backward or turning it to the side.

The exact cause of BPPVi remains unclear, but it is thought to be related to the development of the vestibular system in young children. Unlike adult BPPV, which is often attributed to dislodged otoconia (calcium carbonate crystals) in the inner ear, BPPVi is not typically associated with these calcifications. Instead, theories suggest a temporary dysfunction or immaturity of the vestibular apparatus. The symptoms are usually transient, lasting for seconds to minutes, and can occur during activities such as being picked up, lying down, or during play.

Diagnosis of BPPVi is primarily based on a thorough clinical history and observation of the child's symptoms during positional maneuvers. It is important to differentiate BPPVi from other causes of dizziness or disequilibrium in children, such as neurological disorders, otitis media, or anxiety. Treatment is generally supportive, as the condition tends to resolve spontaneously within months, typically by the age of 2 to 3 years. Reassurance for parents is crucial, and in some cases, vestibular rehabilitation exercises may be considered, although their efficacy in infants is less well-established than in adults.