Lomerizine therapy for the treatment of benign paroxysmal vertigo of childhood transitioning into atypical basilar migraine: A case report

We report a rare case of benign paroxysmal vertigo (BPV) of childhood transitioning into basilar migraine (BM) that was effectively treated with lomerizine. A 6-year-old male visited our hospital complaining of repeated attacks of vertigo for 3 months. The patient's vertigo attacks lasted for several hours and were accompanied by nausea, vomiting, intense fear and loss of consciousness. No nystagmus was observed during the vertigo attacks. Blood tests and imaging examinations revealed no abnormal findings. The results of electronystagmography and the caloric test were unremarkable. Pure-tone audiometry revealed profound right-side sensorineural hearing loss. Among the differential diagnoses, delayed endolymphatic hydrops, epilepsy and BM were considered. Delayed endolymphatic hydrops was considered unlikely since no nystagmus occurred during the vertigo attacks and there was no change in hearing; electroencephalography revealed no epileptic seizure waves. The attacks of vertigo were well-controlled with lomerizine. The patient was diagnosed with BM since the use of lomerizine, an agent for the treatment for migraine, was effective. Since it was reported that BPV is closely related to migraine and the onset of the vertigo attacks was accompanied by a loss of consciousness, we concluded that this patient had BM transitioning from BPV.