ÇOCUKLUK ÇAĞINDA VERTİGO: BAŞ DÖNMESİ OLAN ÇOCUKLARI NASIL DEĞERLENDİRELİM?

Abstract

Objective
 Vertigo is a complaint consisting of wide spectrum
 of diagnoses in childhood. The aim of this study was
 to evaluate clinical characteristics and differential
 diagnosis of pediatric patients with vertigo.
 Material and Methods
 In this retrospective study, the medical records of
 a hundred patients who presented to the Pediatric
 Neurology Outpatient clinic with the complaint of
 vertigo between January 2018-January 2021 were
 reviewed. Patients were evaluated for age, gender,
 family history, duration of symptoms, frequency of
 attacks, provoking factors, accompanying symptoms,
 physical examination, laboratory findings and final
 diagnosis.
 Results
 The mean age was 12.39 years. The majority of the
 patients were males (64%). There were different
 causes of vertigo, but the most common two were
 infection (34%) and psychogenic vertigo (25%). The
 other frequent reasons were orthostatic hypotension
 (16%) and vitamin B12 deficiency (9%). Most of the
 patients had symptom duration for less than one
 month (46%), and the attacks were primarily seen
 (65%) every day. Patients explained their attacks as
 the motion of the surrounding (61%), spinning (27%),
 imbalance (20%), and others. The most common
 accompanying symptoms were fatigue (60%) and
 headache (54%). Laboratory data revealed vitamin
 B12 deficiency in nine patients; all other tests were
 in the normal range. Thirty-nine patients had cranial
 MRI, only 2 of them revealed abnormal findings, one
 of them was responsible for vertigo.
 Conclusion
 Vertigo in children creates a profound sense of
 anxiety both in parents and physicians leading to
 excessive number of functional testing and imaging
 examinations. Evaluation should begin with detailed
 history and comprehensive physical evaluation to
 avoid superfluous testing and diagnostics. Serious
 cases are fortunately rare and can be detected by
 careful clinical examination.