Neuropediatrics 2011; 42(04): 129-134
DOI: 10.1055/s-0031-1283158
Review Article
Georg Thieme Verlag Stuttgart · New York

Vertigo and Dizziness in Childhood − Update on Diagnosis and Treatment

K. Jahn
1  Ludwig-Maximilians University of Munich, Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFBLMU ), Munich, Germany
2  Ludwig-Maximilians University of Munich, Department of Neurology, Munich, Germany
,
T. Langhagen
1  Ludwig-Maximilians University of Munich, Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFBLMU ), Munich, Germany
,
A.S. Schroeder
1  Ludwig-Maximilians University of Munich, Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFBLMU ), Munich, Germany
3  Ludwig-Maximilians University of Munich, Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner’s Children’s Hospital, Munich, Germany
,
F. Heinen
1  Ludwig-Maximilians University of Munich, Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFBLMU ), Munich, Germany
3  Ludwig-Maximilians University of Munich, Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner’s Children’s Hospital, Munich, Germany
› Author Affiliations
Further Information

Publication History

received 30 March 2011

accepted 19 June 2011

Publication Date:
15 July 2011 (online)

Abstract

Vertigo and balance disorders are not uncommon in children. The prevalence of vestibular vertigo in 10-year-Dolds is estimated to be 5.7%. The most common cause is vestibular migraine which accounts for almost 40% of the diagnoses. In adolescents, the incidence of somatoform vertigo syndromes increases. Vestibular function can be reliably evaluated at the bedside by the head-impulse test for vestibulo-ocular reflex function, ocular motor testing of the central vestibular system, and balance tests for vestibulo-spinal function. Vestibular migraine is treated by behavioural and drug therapies. Somatoform vertigo improves if information about the disorder and behavioual advice are provided. Sometimes psychotherapy is useful; drug therapy is recommended in severe cases. Other common vestibular disorders in children include benign positioning nystagmus and labyrinthitis. In summary, the underlying causes of vertigo and dizziness in children can be diagnosed on the basis of patient history and clinical bedside testing. Reponses to caloric irrigation of the ears, rotational chair testing, posturography, and video-oculography can be used to ascertain the diagnosis. Brain imaging is indicated in patients presenting with subacute central vestibular signs. The majority of syndromes have a favourable prognosis and can be successfully treated.