Dysautonomia and Headache in the Pediatric Population

Abstract

Dysautonomia and headache are 2 common diagnoses within pediatric neurology; in the case of dysautonomia, a lack of consideration may lead to misdiagnosis. Despite being common conditions, there is a lot to learn about each individually as well as collectively. Many of the symptoms between headache and dysautonomia patients overlap making the diagnosis difficult. Migraine patients often exhibit symptoms of dysautonomia, namely postural orthostatic tachycardia syndrome (POTS); yet these symptoms are overlooked or lumped in as a part of their migraine diagnosis. The distinction or coexistence between dysautonomia and headache is identified through a thorough history, a full exam, and an open mind. This is crucial for the treatment and outcomes of these patients. Struggles arise when critical treatment differences are overlooked because dysautonomia is not considered. In this review, we will look at the epidemiology of dysautonomia and headache with focus on POTS and migraine. We will then compare the clinical features of both conditions as well as some hypothesized pathophysiology overlaps. We will conclude by summarizing the diagnostic approach and multitiered treatment options for POTS and migraine.

Vertigo and Dizziness in Children: An Update

“…Neurological diseases (10%) included life-threatening central nervous system (CNS) conditions, such as brain tumours, meningitis and encephalitis. Dysautonomia, a newly recognized disorder of the autonomic nervous system consequent to impairment of the sympathetic or parasympathetic component (https://my.cleveland linic.org/health/articles/6004-dysautonomia, 20 September 2021, accounted for 46% of the neurological diagnoses [17] (Figure 6). Neurological disorders, including central nervous system diseases, represent 18.3% of diagnoses of children under 5 years old, while audio-vestibular diseases accounted for 9.75% (Figure 3).…”

Evaluation and management of paediatric vertigo

“…One of the most substantial differences in the management of vertigo over the last decade has been an increased understanding of the most common causes of paediatric dizziness [1 & ,3,7,10]. A nonexhaustive list is presented in Table 1 [59][60][61][62][63][64][65][66][67][68][69][70].…”

Dehydration and Headache

“…Eating small meals throughout the day and utilizing compression stockings or abdominal binders can prevent blood pooling. Graded aerobic exercise is also key to build muscle and prevent deconditioning [ 41 ]. When symptoms are severe or remain bothersome despite lifestyle measures, pharmacotherapy should be utilized.…”