Original Article
Creatine kinase MB (CK-MB) in benign paroxysmal vertigo of childhood: A new diagnostic marker

https://doi.org/10.1016/j.jpeds.2004.10.062Get rights and content

Objectives

To evaluate the relation between creatine kinase-MB (CK-MB) and benign paroxysmal vertigo in childhood (BPV).

Study design

We prospectively evaluated and followed serum CK-MB in 22 children with BPV diagnosed between 1998 and 2003.

Results

The average age of debut for BPV was 1.7 years, and follow-up time was 2.8 years. The CK-MB values were elevated in all children. CK-MB values were persistently increased (mean, 6.0 μg/L) during the study period and were not related to duration of BPV, time since last attack, or frequency of attacks. CK-MB became normal in 7 children who recovered during the study period. After the initial increased CK-MB value, CK, aspartate aminotransferase, and cardiac troponin I (in 16 children) were measured as markers of muscular disease. CK was slightly increased in 7 (31.8%) and aspartate aminotransferase in 14 (63.6%) of the children. Cardiac troponin I was normal in all children.

Conclusions

In this study, serum CK-MB levels were associated with BPV. These findings indicate a possible muscular involvement in BPV. Further studies will be needed to determine if CK-MB is useful as a diagnostic test for BPV.

Section snippets

Methods

From December 1998 to March 2003, 22 children were diagnosed with BPV at the Department of Pediatrics, Falun Hospital. All children were referred to and followed up by one of the authors. The Department of Pediatrics serves 67,000 children up to the age of 18 years.

The diagnosis was based on preset criteria. In many cases, electroencephalography, CT of the brain, and MRI were performed to exclude other conditions. The criteria were (1) recurrent episodes of vertigo and a sensation of spinning

Results

Of the 22 children who were diagnosed with BPV from December 1998 to March 2003, 15 (68.2%) were girls and 7 (31.8%) were boys. Average age when BPV was diagnosed was 2.1 (SD, 0.8) years, and history of debut age was 1.7 years (SD, 0.9). No child had an onset after 4 years of age. Average follow-up time was 2.8 years (SD, 1.4; range, 12 months to 5 years). The number of episodes per month at peak was 1 in 4 children, 2 in 5 children, 3 to 19 in 6 children, and more than 24 episodes per month in

Discussion

There are no known markers in serum for the diagnosis of BPV. The elevation of CK-MB levels in children with BPV was first discovered by chance in the first patient in this series. This finding led to the current study. Our results show that CK-MB was increased during BPV and in a large proportion of patients at each observation. In no case was CK-MB normal at the first two observations after diagnosis of BPV. A prospective, population-based study would be required to determine sensitivity and

References (13)

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Supported by the Center for Clinical Research, Falun, Sweden.

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