1.6.2 Benign paroxysmal vertigo

A four-year-old boy has had five brief spells of dizziness over the past six months. His mother reports no warning sign ever precedes an attack, and each one is at its very worst the instant it starts rather than building gradually. During two of the episodes he has turned strikingly pale, and staff have commented on his pallor lasting throughout the spell. He has not lost consciousness on any occasion, and every episode has ended on its own within a couple of minutes, with no residual symptoms afterwards. The patient also has occasional headaches, and thorough review has found no other disorder responsible for these headaches. His neurological examination in clinic today, and by report between previous episodes, has been consistently normal, including gait and tone. His mother would appreciate an assessment of these recurrent dizzy episodes.