Vestibularisdiagnostik im Kindesalter

Schwindel tritt bei Kindern mit steigender Inzidenz auf, nach der Pubertät häufiger bei Mädchen als bei Jungen. Dabei machen mit Migräne assoziierte Schwindelformen bis zu 50% der Fälle aus. Daneben findet man klassische peripher-vestibuläre Erkrankungen wie die Neuropathia vestibularis, den benignen paroxysmalen Lagerungsschwindel (BPLS) und die hydropische Innenohrerkrankung. In diesem Beitrag wird die Vestibularisdiagnostik bei pädiatrischen Patienten näher beleuchtet.

Abstract

Dizziness is a common symptom not only in adults but also in children, with a rising incidence in recent years. The prevalence of vestibular disorders in the pediatric population ranges between 0.4% and 15%, depending on the study. While both genders are equally affected in childhood, females are more frequently diagnosed after puberty, a trend persisting into old age. Migraine-associated vertigo, such as benign paroxysmal childhood vertigo (BPVC) and vestibular migraine, accounts for up to 50% of pediatric cases. These conditions manifest as sudden, short-lived dizziness episodes with rapid recovery. In addition to migraine-associated forms, classical peripheral vestibular disorders—including vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and endolymphatic hydrops—can also occur in children but are often diagnosed late due to non-specific symptoms and difficulties in symptom description.

Vestibular function is crucial for cognitive and motor development, influencing spatial orientation, attention, and executive functions. Children with vestibular dysfunction often exhibit delayed motor milestones and compromised postural control. Despite the availability of objective diagnostic methods like the video head impulse test (vHIT) and vestibular-evoked myogenic potentials (VEMPs), there is no standardized pediatric vestibular diagnostic protocol. Therefore, vestibular disorders should be considered in differential diagnoses, especially in children with dizziness, motor developmental delays, or those undergoing cochlear implant surgery. Early diagnosis enables targeted interventions, such as vestibular physiotherapy, to support affected children. This review highlights the necessity of pediatric vestibular diagnostics and proposes a practical approach to assessing balance function in children.

Kernaussagen

• Schwindel tritt auch im Kindesalter auf, mit einer Prävalenz von 0,4–15%.

• Migräne-assoziierte Schwindelformen wie BPVC und vestibuläre Migräne machen bis zu 50% der Fälle aus.

• Klassische peripher-vestibuläre Erkrankungen sind bei Kindern oft unterdiagnostiziert.

• Vestibuläre Störungen können die motorische Entwicklung und kognitive Funktionen beeinträchtigen.

• Der Video-Kopfimpulstest (vKIT) und VEMPs ermöglichen eine objektive vestibuläre Diagnostik ab dem Säuglingsalter.

• Es gibt bislang keinen standardisierten Algorithmus für die vestibuläre Diagnostik im Kindesalter.

• Kinder mit unklaren Entwicklungsverzögerungen sollten vestibulär untersucht werden.

• Vor einer Cochlea-Implantation wird eine vestibuläre Testung empfohlen.

• Eine frühzeitige Diagnosestellung ermöglicht eine gezielte Therapie und vestibuläre Rehabilitation.

• Eine bessere interdisziplinäre Zusammenarbeit kann die Diagnostik und Therapie optimieren.

Schlüsselwörter

Vestibularisdiagnostik - Kindesalter - Schwindel - vestibuläre Funktionsstörungen - Video-Kopf-Impulstest

Keywords

vestibular assessment - children - pediatric dizziness - vestibular disorders - video head impulse test

Publikationsverlauf

Artikel online veröffentlicht:
04. August 2025

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