What causes dizziness and sleep attacks in children?

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Your son’s main symptoms are as follows:

1. Dizziness (short-lasting, random).
2. Daytime sleepiness (falls asleep at school or on the train).
3. Headaches (occasional).

Daytime sleepiness at this age, falling asleep suddenly in public places, or at school, is not normal. Possible causes for your son's condition can be:

1. Sleep disorders (such as narcolepsy, sleep apnea, or poor sleep).

2. Metabolic or hormonal issues (thyroid, cortisol, blood sugar).

3. Less commonly, seizures present as brief “staring” or lapses in awareness.

The causes for the Dizzy spells can be the following:

1. Low blood pressure.

2. Inner ear (vestibular) problems.

3. Migraine-related dizziness.

4. Small seizure episodes. Since they last from seconds to minutes, both non-neurological (ear, nose, and throat -ENT or cardiac) and neurological causes should be considered.

5. Headaches - In children, most are benign (such as migraine, tension headaches, or eye strain).

However, I suggest you keep a watch for other symptoms besides dizziness and sleep episodes. such as:

1. Worsening severity.

2. Morning vomiting.

3. Vision changes.

4. Weakness or balance problems.

However, a normal neurological examination and a normal electrocardiogram (ECG) are very reassuring. The eye test also showed only minor strain.

I suggest you follow these next steps:

Await blood test results (thyroid function tests, blood glucose, cortisol, and iron), as these can explain fatigue and dizziness. If your son's blood results are normal, consider undergoing further investigations such as:

1. Sleep study including polysomnography, multiple sleep latency test (MSLT) to assess for narcolepsy or other sleep disorders.

2. Electroencephalogram (EEG) to rule out subtle seizure activity.

3. Magnetic resonance imaging (MRI) brain, especially if symptoms worsen (headaches or dizziness).

I also suggest you follow the instructions mentioned below:

1. Keep a symptom diary and note time, duration, triggers, and recovery from dizziness or sleep attacks.

2. Ensure your son gets good sleep, adequate hydration, and regular meals.

I suggest you seek urgent medical review in case of the following:

1. Sudden collapse with loss of awareness.

2. Persistent morning vomiting or severe headaches.

3. New weakness, double vision, or difficulty walking.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

That is excellent and reassuring. A referral to a sleep specialist is the right step, since the daytime sleep episodes could suggest a sleep disorder like narcolepsy, but we also want to be sure seizures are not missed, which is where an electroencephalogram (EEG) helps.

Magnetic resonance imaging (MRI) is important to rule out structural causes like tumors, malformations, or inflammation, especially with dizziness and headaches.

While waiting for results, I suggest:

1. Keep a symptom diary: Note when dizziness or sudden sleep episodes occur, what your son was doing, how long it lasted, and how he felt afterwards. This really helps specialists.

2. Watch for red flag signs: Worsening headaches (especially early morning or with vomiting), sudden vision changes, weakness, unsteadiness, or prolonged confusion after episodes. If these occur, seek urgent care.

3. Encourage good sleep hygiene and avoid caffeine or energy drinks.

You are already doing the right things. The combination of blood work, MRI, sleep study (polysomnography), and EEG should give a clear direction.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.