Abstract
(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases.
Highlights
Vertigo in a pediatric age is not an infrequent condition, with about a 10% prevalence in most clinical trials [1,2,3,4,5,6,7,8,9,10,11,12,13]
Exclusion criteria were patients with symptoms not related to vertigo, subjects examined for other reasons, and patients not accompanied by parents, relatives, or legal guardians
benign paroxysmal vertigo of children (BPVC) was present in 8.5% cases (40/472), especially in females (67.5% -27/40vs. 32.5% -13/40-) and in children under the age of 7 (52.7% -29/55- vs. 2.6% -11/417-)
Summary
Vertigo in a pediatric age is not an infrequent condition, with about a 10% prevalence in most clinical trials [1,2,3,4,5,6,7,8,9,10,11,12,13]. The variability of the clinical presentation of vertigo justifies a multi-specialist diagnostic approach, involving a neurotologist but, in selected cases, a psychiatrist, psychologist, cardiologist, pediatrician, geneticist, traumatologist, physiatrist, ophthalmologist, and a dentist [17]. The prevalence data of the different forms of vertigo studied in the scientific literature are highly variable due to the heterogeneity of the examined samples, the different methods of clinical evaluation or statistical processing of the data, and the different cultural settings of the authors (neurologist, pediatrician, otolaryngologist) [14]
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