\s=b\ Thirty-three cases of benign paroxysmal vertigo in childhood have been seen at our institution since the disorder was recognized ten years ago. Progression from paroxysmal torticollis of infancy to paroxysmal vertigo of childhood is documented. Ear infections and allergy appeared causative in a few, but not most, of the cases. The most important consideration for the pediatrician is to rule out epilepsy and brain tumor. Parents should be reassured that the condition is benign, and that the attacks will cease in a few months or years.Benign paroxysmal vertigo (BPV) of childhood is a disorder charac¬ terized by brief attacks of vertigo in small children. It is often mistaken for epilepsy, or confused with early signs of a brain tumor. First described in the neurological literature,1 -this con¬ dition has received little attention in pediatrie journals.1" We believe that this is not a rare disorder, and that pediatricians need to be aware of it; therefore, we present our experience with BPV. REPORT OF CASESIn the ten years since Basser's original description,' we have seen 33 patients at the Ochsner Clinic whose illness met most of the following criteria: (1) multiple, brief, sporadic episodes of disequilibrium, anxie¬ ty, and often nystagmus or vomiting; (2) normal neurologic examination; (3) normal electroencephalogram; and (4) abnormal response to caloric stimulation of the ears.Of the 33 patients, 19 were girls and 14 boys. The onset of vertigo was most often between 1 and 3 years of age. Four children began having attacks in the first year, nine in the second year, 11 in the third year, three in the fourth year, and the remaining six after the fourth year. The children generally had from one to four attacks of vertigo per month. One child had attacks more often than weekly, and five had less than one per month. Several children would have clusters of attacks. In 17 cases, the attacks were brief, lasting less than five minutes, sometimes only a few seconds. In ten cases, attacks would last from five to ten minutes, and in six cases the mothers noticed that occasional attacks would last longer than ten minutes.All attacks occurred suddenly, and with¬ out apparent provocation or prodrome. The children would usually appear frightened, and cry out for help. Some would cling to their parents or to furniture for support. Others would fall, or stagger drunkenly with the attacks. Pallor and sweating were common. Vomiting during the attacks occurred in seven patients. Nystagmus was noted in eight children, and torticollis in ten. The attacks would end quickly, and the children appeared to be completely healthy between spells. Many children, although young, were able to describe definite rota¬ tional sensations. One 2-year-old would say "round, round" during the attacks, and "all gone" at the end of the attack. Eight patients felt the room, floor, or world was spinning, three said they were rotating, two reported a sensation of falling. Five said they felt dizzy, and one said he was "earachy." General physical ex...

No abstract

No abstract

No abstract

Three cases of chronic extreme eosinophilia with granulomatous lesions in the liver have been studied. A larval nematode observed in sections from the liver of one patient has been identified either as Toxocara canis or Toxocara cati, common cosmopolitan ascarids of dogs and cats; available evidence favors the former. The term visceral larva migrans is proposed for this type of parasitism, known in animals but not previously described in humans. It is related to better known cutaneous larva migrans, in that both are usually caused by infective stage larvae of nematode parasites of other animals. Man being an abnormal host, either has unfavorable tissue reactions or otherwise fails to provide stimuli for usual tissue migration and development of the parasite. As a result, larvae remain active for variable periods in various tissues. Similar but less severe and less prolonged reactions occur when the larvae of normal nematode parasites of man invade the tissues of a hyperimmune individual. Visceral larva migrans is usually a relatively benign disease, characterized chiefly by sustained eosinophilia, pneumonitis and hepatomegaly, and probably is due both to direct tissue damage by migrating larvae and to allergic responses to their products. Its severity varies with the number of larvae in the tissues and the immune or allergic state of the infected individual.