Spotlight: Hearing & Balance in the News
December 5, 2023
Did you know children can also suffer from chronic or episodic headaches? It is important to recognize the symptoms early for best outcomes. Read more.
Practical Pain Managment
Montclair, New Jersey
October 30, 2023
Falling Back: BPPV and Relapse of Vertiginous Symptoms
Though it's not an official condition, "October Slide" refers to the worsening of symptoms that those with chronic illness begin to feel as the season changes.
Vestibular Disorders Association
January 31, 2024
The One Thing Audiologists Say You Should Never, Ever Do
Protecting your hearing isn't always as intuitive or obvious a measure as, say, wearing a helmet or seatbelt. But experts say it should be! Read more.
Six Common Types of Migraine in Children and Youth
Practical Pain Management | Montclair, New Jersey
Posted here December 5, 2023
According to the National Headache Foundation, 20% of school-aged children from 5 to 17 are prone to headaches. Of that population, 15% will suffer from tension-type headaches, while the other 5% will be prone to migraine (this number is often reported as up to 10%).
Headaches and migraine can happen to anyone, at any age, including young children. Not only that, but the intricacies and symptoms of the disorder are different in children than in adults; common migraine symptoms such as nausea, vomiting, and sensitivity to light and sound are not always prevalent in child sufferers. Children, in addition, cannot always vocalize or describe in detail what they are feeling, which makes diagnosis even more difficult. These patients may go undiagnosed for years, leading into adulthood, which can take a toll on their emotional and mental well being.
The American Migraine Foundation outlines a few key differences between children’s migraine and those of adults:
migraines in children are typically shorter in duration and occur less frequently
the pain children experience tends to be more bilateral, such as across the forehead, rather than unilateral (on one side of the head)
while common symptoms may not be reported, a lot can be deferred from a child’s behavior, such as wanting to sleep or lay down in a dark, quiet room.
Here are a few of the types of migraine that commonly affect children:
1. Common Migraine Without Aura
According to John Hopkins Medicine, migraines may start early in childhood, with an average onset around age 7 for boys and 10 for girls. Early triggers may include a family history of migraine, or correlation with menstrual periods for females. According to the Migraine Trust, children can often feel or be sick (nausea) after a migraine attack, which brings relief from symptoms and often represents the end of a migraine attack. Typical adult migraine symptoms such as muscle tenderness and light/sound sensitivities may be seen. Certain early indicators of migraine are specific to children, including car or motion sickness, cyclic vomiting periods, and infant colic.
2. Classic Migraine With Aura
According to the Cleveland Clinic, young children under the age of 10 often experience classic migraine in the late afternoon, and as they get older (12 and above), the onset may change to early morning. Aura is a warning sign that a migraine is about to begin (it also can occur as the migraine is attacking), usually occurring about 10 to 30 minutes before onset. In some cases, aura appears as early as the night before the onset. The most common auras are visual and include blurred or distorted vision, blind spots, or the appearance of flashing or moving lights. Other auras may include speech disturbances, motor weakness, or sensory changes. About 10% of children with migraine experience aura, according to the Migraine Trust; the symptoms can last up to an hour.
3. Tension-type Headache
Tension-type headaches are the most common type of headache in both children and adults, and are usually caused by secondary factors such as stress, certain foods, or environmental triggers. According to the Mayo Clinic, tension headaches can cause: a pressing tightness in the muscles of the head or neck; mild to moderate, non-pulsating pain on both sides of the head; pain that’s not worsened by physical activity; and a headache that is not accompanied by nausea or vomiting, as is often the case with migraine. Tension-type headaches typically last from 30 minutes up to several days in severe cases. Younger children may withdraw from normal activities and want to sleep more, according to the Mayo Clinic; a good indicator that a tension headache or migraine has occurred. Sleep, according to the Migraine Trust, can help headache and migraine attacks go away for children, even for as little as a 15-minute nap.
4. Abdominal Migraine
Some children have distinct abdominal pain that accompanies a migraine, and while they typically grow out of this condition, they may go on to develop constant migraine in adulthood. Abdominal migraine is prevalent in children from ages 5- to 9-years-old and occurs in 4% of children, with a mean onset of age 7, according to the American Migraine Foundation. It is recognized as an episodic syndrome that may be associated with migraine. Abdominal migraine pain can be crampy, dull, or sharp in nature and can last from a few hours to up to three days. The pain may be described as moderate to severe in intensity, and typically surrounds the bellybutton. Pain can be severe enough to interfere with normal daily activities, and come with a loss of appetite, nausea, vomiting, paleness, or sensitivity to light or sound, according to the American Migraine Foundation. Abdominal pain can also be a sign of gastrointestinal or renal disease, so a thorough evaluation should be conducted to rule out these conditions.
5. Basilar Migraine
According to the International Classification of Headache Disorders (3rd edition), basilar migraine is defined as migraine with aura symptoms clearly originating from the brainstem, with no other motor or retinal weaknesses. According to the Migraine Trust, typical symptoms can include visual disturbances in both eyes, speaking difficulties, hearing problems, tingling in the hands and feet, dizziness, vertigo, or ringing in the ears. Each of these symptoms usually only lasts up to one hour. Many of these symptoms may occur with anxiety and hyperventilation, which makes proper diagnosis challenging. The American Migraine Foundation suggests that migraine with brainstem aura is more common in adolescent females, but notes that it can affect all age groups. However, basilar migraine does exhibit the same female predominance seen overall in migraine.
6. Ophthalmoplegic Migraine
Ophthalmoplegic migraines are headaches with pain surrounding the eye, sometimes with symptoms such as droopy eyelids, double vision, and other sight problems, according to Stanford Health Care. Also known as ocular migraine or retinal migraine, these types of migraine can occur without any noticeable accompanying head pain, according to the American Migraine Foundation. Much like other migraine aura conditions (such as basilar migraine), this migraine is considered to be a result of abnormal electrical activity involving certain regions of the cortex (outer surface) of the brain, according to the American Migraine Foundation. Ocular/retinal migraine features pain at the back of the eye in the retina, and may be the result of a reduction in blood flow to the retina. Harsh lights and screens, eyestrain, and other weakening visual activities can trigger attacks.
What to Do if You Suspect Your Child is Experiencing Migraine
While headaches can seem to be inescapable, there are many things that both the parent and child can do together to prevent the onset of migraine, such as getting a proper diet, drinking plenty of water, and regularly exercising. Due to these small differences in the characteristics of migraine in young people, seeing a pediatrician or a pediatric headache specialist may be a good first step to helping your child or young teen find relief. Comprehensive evaluations by these doctors and/or specialists may both be a way to determine the specific type of migraine, while also making sure that the head pain isn’t associated with a serious underlying cause, such as viruses, seizures, or mood changes.
For more information, follow this link to the parent site.
Falling Back: BPPV and Relapse of Vertiginous Symptoms in the Fall Season
Vestibular Disorders Association | Portland, Oregon
Posted here October 10, 2023
Published November 14, 2022
Though it’s not an official condition, “October Slide” refers to the worsening of symptoms that those with chronic illness begin to feel as the season changes (Normalyte, 2021). Many people report relapse of symptoms such as increased fatigue, dizziness, lightheadedness, brain fog, and joint or muscle pain.
It’s no coincidence that this occurs in the fall season. With the change in weather, people tend to spend less time outdoors which may result in decreased vitamin D levels. Low vitamin D can be responsible for ailments such as fatigue, muscle pain, brain fog, and dizziness (Smith, 2022). Unfortunately, older adults have a decreased ability to absorb fat-soluble vitamins so are at higher risk for dizziness caused by vitamin D deficiency (Smith, 2022).
BPPV AND VITAMIN D
Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. Often idiopathic, BPPV occurs when calcium crystals in the inner ear become dislodged and move into the semicircular canals. This causes the inner ear to misinterpret changes in head position or movement, which causes the individual to experience dizziness (Mayo Clinic 2022). Vitamin D deficiency may be one of the causes of BPPV (Abdelmaksoud et al, 2021). Other studies suggest that those who are vitamin D deficient experience more intense symptoms of BPPV (Sheikhzadeh et al, 2016). The main role of vitamin D in the body is to help maintain normal blood levels of calcium and phosphorus and to help absorb calcium (Starr, 2018).
Fighting the October Slide
Being proactive is key. Once the weather begins to change, many people with chronic illness develop and follow a self-care plan. This may include a balance of diet, rest, and relaxation. Though each experience may differ, it is a good idea to connect with a medical provider when relapse occurs. Professionals may recommend patients experiencing symptoms of “October Slide” eat foods that are high in vitamin D, participate in regular physical activity, drink plenty of water, and increase calcium intake (Smith, 2022). Medical professionals may also consider changes in medication to combat worsening of symptoms for chronic conditions (Normalyte, 2021). Timely diagnosis is key in determining a root cause for symptoms and appropriate treatment options.
Written for VEDA.org by Monica Allgauer, AuD
For further information regarding tools and resources, follow this link to visit VeDA’s website.
The One Thing Audiologists Say You Should Never, Ever Do if You Want To Protect Your Hearing as You Age
Parade | Nashville, Tennessee
Posted here January 31, 2024
Published January 2024
Audiologists agree that repeated exposure to loud noise without hearing protection is the biggest no-no if you want to protect your hearing as you age. But what constitutes loud noise? Turns out, "loud noise" is compromised of more than you think.
According to Joey Remenyi, MA, vestibular audiologist and author of Rock Steady: Healing Vertigo Or Tinnitus with Neuroplasticity, it means any environment in which "you need to yell to be heard." That means it isn't just the usual suspects of concerts, fireworks, machinery, airplane tarmacs or firing ranges—even loud parties can impact your ears.
"It's an accumulation effect," Remenyi explains. "So the louder the noise, the more potential damage to the inner ear hair cells, and the longer the time exposed, the increased risk of permanent hearing loss too."
A close second worst thing you can do for your hearing? It's shoving Q-tips (or anything else!) into your ears.
In fact, "cleaning" your ears with cotton swabs just pushes cerumen (ear wax) deeper and further into your ear canal, Lewis says, explaining, "This can cause cerumen impaction, which can be painful to remove. You also run the risk of puncturing your eardrum when you place Q-tips deep in the canal, which can lead to long-term hearing issues."
The full article can be found here.