Cause Of Vertigo In Children Research Articles

Vertigo and dizziness in child: a clinical analysis in 120 cases

Objective: To investigate the disease composition, clinical features, diagnosis, and treatment characteristics of vertigo in children. Methods: A total of 120 children with vertigo diagnosed and treated in the Department of Otorhinolaryngology, Children's Hospital, Capital Institute of Pediatrics in Beijing from February 2018 to February 2022 were retrospectively analyzed to explore the clinical characteristics of common peripheral vertigo in children and to summarize the experience of diagnosis and treatment. Results: The etiological composition of 120 cases of vertigo in children are as follows: 63 (52.5%) cases of vestibular migraine of childhood (VMC), 19 (15.8%) of recurrent vertigo of childhood (RVC), 11 (9.2%) of probable vestibular migraine of childhood (PVMC), 10 (8.3%) of secretory otitis media (SOM), 6 (5.0%) of persistent postural-perceptual dizziness (PPPD), 4 (3.3%) of benign paroxysmal positional vertigo (BPPV), 2 (1.7%) of vestibular neuritis (VN), 2 (1.7%) of Meniere's disease (MD), 2 (1.7%) of inner ear malformation (IEM), and 1 (0.8%) of vestibular paroxysmal syndrome (VP).The major cause of vertigo in children of different ages was different. SOM was the most important cause in preschool children, followed by RVC and VMC; VMC was the most important cause in school-age children, followed by RVC; and MD and BPPV were exclusive found in adolescents. The incidence rate of PPPD was higher in adolescents than in preschool and school-age children. Children with vertigo had good prognosis in general. Conclusions: VMC, RVC and SOM are the most common causes in vertigo in children, and their proportion was different in different aged children. Transforming abstract feelings into specific information is the skill required for collecting medical history of children with vertigo. Considering the age and cooperation of children, appropriate hearing and vestibular examination techniques are recommended. We should pay more attention to the mental health of children with vertigo and their parents.

A Basilar Artery Dissection Mimicking Acute Labyrinthitis in A 15-Year-Old Girl

Basilar artery dissection (BAD) is a rare cause of vertigo in children. A 15-year-old girl presented with sudden vertigo and unilateral hearing loss. Magnetic resonance imaging revealed posterior circulation infarction caused by BAD. After antiplatelet therapy, intratympanic injections of dexamethasone and vestibular rehabilitation, her symptoms improved. We report this case of BAD, which might be mistaken for acute peripheral vestibular disorders in the early stage.

Migraine Associated Vertigo in Children and Teenagers Epidemiology and Treatment .

Objective: describe the symptoms and outcome of vertigo in a pediatric population. Patients. The study included all children and teenagers who presented with dizziness in the otoneurology northwest general hospital Peshawar department from 2014 to 2021. Study design:A retrospective observational study Place and duration of study: from 02 jan 2014 to 02 jan 2021department of ENT kth hospital peshawar Material And Methods: the study was carried out between 02 jan 2014 to 02 jan 2021 in the ENT KTH hospital in Peshawar. Children under the age of 13 who had normal otoscopy, a least one dizziness attack, and no prior neurological evaluation were included in the research. Children who have severe otitis media or otitis media with fluid experience dizziness. The current research concentrated on kids and teenagers who experienced dizziness despite having acceptable orthoscopic findings. Using SPSS 24, the sample number was determined. Results: Seventy-four young participants, with ages averaging 10.5 years, partook in the investigation. Table 1 illustrates the profiles and clinical signs of these individuals. Remarkably, four patients showed location nystagmus, five had post-head-shaking nystagmus, and ten tested positive on the head impulse test. Spontaneous nystagmus occurred in 30% of the sample. Fifty-four reported using English as their primary language. Twenty-three children completed the research, with an 18% dropout rate. Notably, as per Jongkees' equation, 68% of ENG patients manifested aberrant caloric examination results, classified as canal paresis exceeding 26% or orientation preponderance over 30%. Additionally, aberrant spatial nystagmus appeared in six cases. The research uncovered an assorted range of causes for vertigo in youngsters, with comparable symptomatic demonstrations. The outcomes differed depending on the etiology, underscoring the significance of tailored analysis, treatment, and follow-up care. Collaborative efforts with medical professionals are absolutely crucial for accurate diagnosis and effective remedial approaches, minimizing the necessity for unnecessary laboratory testing. Conclusion: Numerous causes of vertigo in children may manifest similar symptoms. Hospitals And Clinical Results Vary Based On Etiology. In each case, the diagnosis should direct treatment and follow-up. Close coordination with medical professionals is frequently required to get the right diagnosis and treatment without undergoing unnecessary lab testing. Keywords: Vertigo, Children, Teenagers, Epidemiology, Treatment

Characteristics of Benign Paroxysmal Positional Vertigo in Young Children.

This study aimed to determine the clinical characteristics of benign paroxysmal positional vertigo (BPPV) in young children. Retrospective case review. All children <10 years old that have been diagnosed with BPPV at our pediatric vestibular program between December 2012-July 2021 were selected. Clinical features were identified by medical record review, including demographics, comorbidities, canal involvement, response to treatment, and incidence of recurrence. A total of 34 children were diagnosed with BPPV with a mean age of 7.9 years old (SD ± 1/7; range 5-9) at the time of diagnosis and a male:female ratio of 1:1. Involved semicircular canals included posterior in 82% (n=28), horizontal in 41% (n=14), and superior in 24% (n=8) of patients, respectively. Comorbid diagnoses included migraine (n=14), concussion (n=10), acute vestibular syndrome (n=4), and persistent postural perceptual dizziness (n=6). Recurrence with initially confirmed resolution occurred in 10 patients (29%) with a mean of 2.5 recurrences per patient (SD: 2.2; range 1-8). A family history of vertigo or migraine was identified in 11 and 17 patients, respectively. BPPV is a cause of vertigo in children that may be overlooked. A relatively high proportion of patients demonstrated horizontal or superior canal involvement, recurrence, and additional comorbid causes of dizziness. Thus, providers evaluating young children with dizziness should perform diagnostic maneuvers to evaluate BPPV of all semicircular canals and continue to monitor children after successful treatment for recurrence. 4, Case Series Laryngoscope, 133:694-699, 2023.

Vestibular migraine of childhood

Background: Vestibular migraine and benign paroxysmal vertigo are the most common causes of vertigo in children and adolescents. This is a review of vestibular migraine of childhood dizziness.Current Concepts: In children and adolescents, the symptoms of dizziness or vertigo are not well defined. Thus, few studies have investigated the characteristics of dizziness or vertigo in children and adolescents. Vestibular migraine is categorized as episodic syndromes associated with migraine in the International Classification of Headache Disorders, 3rd edition. Despite vertigo’s various clinical features and duration, vestibular migraine can be diagnosed only when a migraine accompanies vertigo from 5 minutes to 72 hours. Benign paroxysmal vertigo is more common in children and adolescents than vestibular migraine. Benign paroxysmal vertigo is considered one of the precursor syndrome of migraine, and the duration of vertigo is short from seconds to minutes.Discussion and Conclusion: Vestibular migraine is common in older children and adults who need a differential diagnosis. This review might be helpful to diagnose, evaluate, and treat children with vestibular migraine and to reassure their parents.

Vestibular Migraine in Adolescents

Migraine is a recurrent throbbing headache that affects one side of the head and is usually related to nausea and decreased vision. Migraine is typically seen in adolescents due to increased use of electronic devices and computers. It is a non communicable disease.10 percent patients with migraine suffer from vestibular migraine. Vertigo in children can lead to migraine and continue in adults too. Preventing the vertigo attacks in children and adolescents can help in the treatment of migraine. Behavioural therapy is an important factor in treatment of migraine in this age. 40% of migraine patients have some associated vestibular symptoms which includes dizziness and disturbed balance. An elevated comorbidity of migraine and vertigo was discovered in several patient categories and later verified at the community level, far exceeding what random chance would predict. Vertigo is substantially more commonly seen in migraine sufferers, particularly those with aura, than in headache-free controls. Migraine is one of the most disturbing diseases in USA, is nearly as common as hypertension and more common than asthma and diabetes. Migraine and vestibular symptoms can coexist with inner ear disorders. It is a difficult condition to diagnose and treat. Multiple temporal patterns are responsible for this. The most common cause of vertigo in children is vestibular migraine (VM). Clinical findings and laboratory test results have been found in a sample of children and adolescents suffering from Vestibular migraine. Recent classification criteria for dizzy children are discussed and their limitations. Migraine is typically seen in adolescents due to increased use of electronic devices and computers. It is a non-communicable disease. 10 percent patients with migraine suffer from vestibular migraine.

Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients.

(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.

How rare is benign paroxysmal positional vertigo in children? A review of 20 cases and their epidemiology

ObjectiveThe clinical features and incidence of benign paroxysmal positional vertigo (BPPV) are not well known in pediatric populations. The aim of this study was to describe the clinical characteristics of pediatric BPPV and to estimate the frequency of pediatric BPPV in the general population. MethodsWe retrospectively reviewed the medical records of 20 children (6–14 years old) diagnosed with BPPV between 2007 and 2017. The age/sex distribution of BPPV for all ages at our hospital and in the Korean Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database were compared. The annual incidence and proportion of children with BPPV were calculated. ResultsBPPV occurred 1.86 times more frequently in girls than in boys. Nine children (45%) had associated comorbidities, such as inner ear disorders and recent head trauma. The posterior and lateral semicircular canals were most commonly involved (n = 9 for each), and recurrence was observed in two patients (10%). Children younger than 15 years accounted for approximately 1% of all BPPV cases. The annual incidence of BPPV was 171.5/100,000 for all ages and 9.5/100,000 in the pediatric population. ConclusionsOur findings suggest that pediatric BPPV is a relatively uncommon cause of vertigo in children and that the rates of related illness and recurrence are high.

Correlation analysis of vertigo etiology and age in children

Objective:To study the etiology of vertigo in children and analyze the relationship between the etiology of vertigo and the age category. Method:One hundred and forty-four cases of children with vertigo or dizziness were selected. All patients received the vertigo questionnaire, audiological, vestibular function and other related examinations. JMP 10.0 was used for statistical analysis. Result:Of 144 patients, 17 cases were preschool age (<6 years old), 101 cases were school age (6-12 years old) and 26 cases were puberty (>12 years old). All patients were mainly distributed between 6 and 10 years old. The most common diagnoses was benign paroxysmal vertigo. The second one was vestibular migraine. Incidence rate of the same disease in different ages was also different. Benign paroxysmal vertigo and vestibular migraine in preschool age, school age and puberty accounted for 58.8%, 42.6%, 0 and 0, 17.8%, 30.8%, respectively. Conclusion:Benign paroxysmal vertigo and vestibular migraine were the most common causes of vertigo in children. Prevalence rate and the etiology was various in different ages. Due to the physical and psychological development of children, analyzing the cause of vertigo in children should be fully considered these characteristics.

Vertigo in children：composition and clinical characteristics

Objective: To explore composition and characteristics of vertigo in children. Method:The diagnosis, medical history and examinations of 46 patients (≤17 years old) with vertigo were studied retrospectively. Result:Of the 46 children patients with vertigo enrolled in this study, 19 patients were with BPVC(41.3%), 11 patients with VM(23.9%),4 patients with BPPV(8.7%), 3 patients with unclassifiable vestibular syndrome(6.5%), 2 patients with Meniere's disease (4.3%), 1 patient with sudden deafness with vertigo, 1 patient with labyrinthitis, 1 patient with vestibular paroxysmal, 1 patient with vestibular neuritis, 1 patient with head trauma, 1 patient with light cupula, 1 patient with benign paroxysmal torticollis (2.2%, respectively). The statistical analysis was conducted among 4 kinds of the most common causes of vertigo in children. There was no significant differences in sex composition among different groups(P>0.05). The mean age and mean age of onset in patients with BPVC were the youngest(P<0.05). Headache was complained more often in patients with VM(P<0.05) and there was no difference in other accompanying symptoms (such as nausea, vomiting and tinnitus) among each groups(P>0.05).Most patients with VM had family history of vertigo or migraine, but not in patients with VM and patients with BPVC(P>0.05). Conclusion:The most common vertigo in children were BPVC, VM and BPPV. The medical history, physical examinations and vestibular function tests can help doctors to diagnose more correctly.

Integrated management of the pediatric patient: from ENT pathology to migraine and epilepsy

Vertigo is a common complaint in neurology and it can also happen in children. A thorough understanding of the possible underlying causes facilitates the correct diagnosis and guides the proper management in such cases. Of high importance is the rapid distinction between life threatening conditions and relatively benign entities when dealing with a child complaining of vertigo, in an acute setting. This article aims to review the different causes of vertigo in children and to present relevant cases from our experience, at ”Dr. Victor Gomoiu” Children’s Hospital, Neurology Department.

Vestibular Migraine in Children and Adolescents.

The goal of this review is to provide an actualized overview on vestibular migraine in childhood and adolescence, with focus on the epidemiology and clinical presentation as well as its treatment. Vertigo spells in childhood can evolve into other periodic syndromes and/or migraine types and persist even into adulthood. Vestibular migraine (VM) and benign paroxysmal vertigo are the most common causes of vertigo in children and adolescents. The diagnostic criteria for VM are dizziness and vertigo, headache, phonophobia and photophobia, and visual aura. The prevention of attacks is the treatment for children and adolescents with VM, as is recommended for migraine with or without aura. Thus, non-pharmacological measures are the first-line option; when these measures fail or daily activities are notably affected, drugs are administrated. Psychological assessment and cognitive behavioral therapy are also important therapeutic measures in this patient group. There is still insufficient research on VM in children and adolescents; future studies on clinical presentation, evolvement, and specific treatment are necessary.

Evaluation and management of vestibular migraine in children: Experience from a pediatric vestibular clinic.

Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatric population. The aim of this study was to evaluate the diagnostic features and response to therapy of VM in children managed at a pediatric vestibular clinic. Twenty-eight patients ≤18 years old with a diagnosis of VM were identified from 208 patients seen at the Balance and Vestibular Program at Boston Children's Hospital from July 2012-July 2014, after excluding 12 patients with a history of major otologic or neurologic surgery, recent concussion, or additional vestibular disorders. Patients' electronic medical records and testing results were retrospectively reviewed. Patients ranged in age from 9 to 18 years old (mean 14.48). All included patients met criteria for definite (n=25) or probable (n=3) VM as defined by the International Classification of Headache Disorders. Rotary chair (n=17), caloric (n=8), cervical vestibular evoked myogenic potential (n=16), and video head impulse (n=3) tests were normal. Medications effectively reduced reported vestibular symptoms in 88% of those treated with tricyclics (n=8), 86% of those treated with cyprohepatadine (n=7), 80% of those treated with topiramate (n=5), 80% of those treated with triptans (n=10), and 25% of those treated with gabapentin (n=4). Vestibular migraine is a common cause of vertigo in the pediatric population that is frequently responsive to medical therapy.

Vertigo and dizziness in children.

Vertigo and dizziness occur with considerable frequency in childhood and adolescence. Most causes are benign and treatable. This review aims to make physicians more alert to the frequent causes of dizziness in the young. Epidemiological data confirm that migraine-related syndromes are the most common cause of vertigo in children. Vestibular migraine and benign paroxysmal vertigo have now been defined by the International Classification of Headache Disorders. About half of the adolescents with vertigo and dizziness show psychiatric comorbidity and somatization. Vestibular paroxysmia has been described as a new entity in children that can be treated with low doses of carbamazepine. To assess vestibular deficits, video head impulses (for the semicircular canals) and vestibular-evoked myogenic potentials (for the otoliths) are increasingly being used. Pediatricians and neuro-otologists should be aware of the full spectrum of causes of vertigo and dizziness in children and adolescents. Vestibular function can reliably be tested nowadays. Although treatment for the common migraine-related syndromes can be done in analogy to the treatment of migraine in general, specific approaches are required for somatoform vertigo, the most frequent diagnosis in adolescent girls.

Is Benign Paroxysmal Vertigo of Childhood a migraine precursor?

IntroductionBenign Paroxysmal Vertigo of Childhood (BPVC) is a common cause of vertigo in children and it is characterized by recurrent attacks of vertigo without warning resolving spontaneously after minutes to hours. It has been considered the equivalent of migraine in childhood. MethodsTwenty-seven patients diagnosed with BPVC were recruited between 1991 and 1997 with a follow up of at least 15 years. The incidence of migraine, inner ear disorders and family medical history is analyzed. ResultsThe average age for the onset of the attacks of BPVC was 3 years and 11 months, and for spontaneous resolution, it was around 5 years and 7 months. The average age for follow up was 18 years. Nine patients developed migraine during adulthood. Nineteen of them had a family history of migraine. ConclusionWe have observed that the prevalence of migraine in patients that had been diagnosed with BPVC is higher than in the general population, which leads us to propose BPVC as a precursor of migraine during childhood.

Clinical evaluation of vertigo in children

Purpose: The purpose of this study was the clinical evaluation of vertigo in children. We focused on diseases which caused vertigo and the results of equilibrium examinations. Methods: The patient records of 40 children who underwent equilibrium examinations at the Department of Otolaryngology, Toyama University Hospital during 2002 to 2006 were retrospectively reviewed. The ages of the subjects ranged from 4 to 15 years. Patients were classified into three groups based on the site of the disease-peripheral vestibular disorders (Group I), central nervous system disorders (Group II) and the others (Group III). Equilibrium examinations consisted of recording of nystagmus under various stimulations using electronystagmography, stabilometry, and the Schellong test. Results: The number of patients in each group were 18 (Group I), 5 (Group II) and 17 (Group III). Eighty eight percent of Group I patients showed canal paresis (CP) including a case of bilateral CP in the caloric test. Group II included patients with serious diseases comprising spinocerebellar degeneration (n=1), cerebellar tumor (n=1) and cerebral infarction (n=1). Patients in this group showed high abnormality in spontaneous nystagmus, eye tracking test, optokinetic nystagmus test, and stabilometry. The cerebellar tumor patient showed apparently weakened visual suppression to caloric nystagmus. Group III included patients with orthostatic dysregulation (n=6), benign paroxysmal vertigo (n=3) and migraine (n=1). Eighty five percent of this group showed abnormal elevation of pulse rate in the Schellong test. Conclusions: 1) Peripheral vestibular disorders occupied more than central nervous system disorders. 2) Orthostatic dysregulation and benign paroxysmal vertigo seemed to be characteristic as causes of vertigo in children. 3) Completing the examinations was not so easy for the children. However, the importance of equilibrium examinations in children for diagnosis is the same as in adults.

Various causes and clinical characteristics in vertigo in children with normal eardrums

Objective: The differential diagnosis of vertigo in children is extensive. Otitis media and middle ear effusion could be the most common causes of vertigo in children, but there are some problems in detecting the other causes for vertigo because they are one of most frequent diseases of childhood. The purpose of this study is to review the clinical characteristics and both the audiological and vestibular findings of vertigo in children with normal eardrums, who do not show otitis media or middle ear effusion, and to assist in making a differential diagnosis of vertigo. Methods: The fifty five children (<16 years old) with vertigo, who visited the Department of Otolaryngology, Ajou University Hospital, Suwon, South Korea between January 1995 and December 2001 were selected for this study. These excluded the patients with abnormal eardrums/tympanograms or those that did not perform questionnaires, audiological, or vestibular evaluations. They were retrospectively analyzed for clinical symptoms, vestibular functions, and differential diagnosis. Results: The most common causes for vertigo in children were migraine in 17 (30.9%) and benign paroxysmal vertigo of childhood (BPVC) in 14 (25.5%). Other less frequent causes included four cases of trauma, two cases each of Meniere's disease, delayed endolymphatic hydrops, benign positional vertigo, and one case only for cerebellopontine angle tumor, seizure, acute vestibular neuritis, juvenile rheumatoid arthritis, leaving ten cases (18.2%) as unclassified. Abnormal findings were noted in 13 (23.6%) in pure tone audiogram, 3 (5.5%) in positioning test, 6 (10.9%) in bithermal caloric test, and 36 (65.5%) in rotation chair test. Conclusions: The vertigo in children with normal eardrums, who did not show otitis media or middle ear effusion, was most commonly caused by migraine and BPVC. These findings have shown to be very different from those with adult vertigo. The evaluation of vertigo in children requires a questionnaire for extensive and complete history taking, audiograms and vestibular function tests. And in selected cases, electroencephalography, hematological evaluation, imaging of the brain or temporal bone should be performed.