Vestibular Syndromes in Childhood and Adolescence

Abstract

Introduction The prevalence of vestibular disorders in childhood ranges from 0.4% to 15%; they may be the result of several factors, but most of the time it's an episodic vestibular syndrome related to migraine equivalents.

Objective To evaluate the diagnostic and therapeutic aspects of children with vestibular signs and symptoms.

Methods The present cross-sectional study evaluated data from the records of patients treated in an outpatient pediatric neurotology clinic over a 10-year period. These data included sociodemographic and clinical variables, results of complementary examinations, the treatment provided, and the clinical evolution.

Results The sample was composed of 117 patients, with 54.7% of female subjects with a mean age of 10 years. The most prevalent diagnosis was benign paroxysmal vertigo of childhood (BPVC) (41.9%), followed by vestibular migraine (16.2%). The most prevalent complaint was vertigo (53.9% of the cases). Most patients (66.7%) had inadequate eating habits. Improvement of symptoms was observed in 40.4% of the patients treated with dietary guidance alone. In 80% of the cases, dietary counseling in combination with vestibular rehabilitation therapy achieved therapeutic success without the need of a drug treatment.

Conclusion The predominant diagnosis was of BPVC, and its close relationship with the personal and family history of migraine, its benign evolution, and the importance of dietary guidance and vestibular rehabilitation for therapeutic success were observed.

Keywords

child - vertigo - migraine disorders - dizziness

Publication History

Received: 09 August 2019

Accepted: 03 November 2019

Article published online:
27 February 2020

• References

• 1 Young YH. Assessment of functional development of the otolithic system in growing children: a review. Int J Pediatr Otorhinolaryngol 2015; 79 (04) 435-442
• 2 Formigoni LG, Medeiros IRT, Santoro PP, Bittar RSM, Bottino MA. Diagnostic approach of vertigo in children. Braz J Otolaryngol 1999; 65: 78-82
• 3 Abu-Arafeh I, Russell G. Paroxysmal vertigo as a migraine equivalent in children: a population-based study. Cephalalgia 1995; 15 (01) 22-25 , discussion 4
• 4 Sousa EC, Siller AL, Tuma VC, Ganança CF, Ganança MM, Caovilla HH. Relação entre dificuldades de leitura e escrita e sintomas e sinais de vestibulopatia periférica em crianças em idade escolar. ORL 2008; 26: 112-117
• 5 Martín Sanz E, Barona de Guzmán R. [Benign paroxysmal vertigo of childhood: categorization and comparison with benign positional paroxysmal vertigo in adult]. Acta Otorrinolaringol Esp 2007; 58 (07) 296-301
• 6 Balatsouras DG, Kaberos A, Assimakopoulos D, Katotomichelakis M, Economou NC, Korres SG. Etiology of vertigo in children. Int J Pediatr Otorhinolaryngol 2007; 71 (03) 487-494
• 7 Wiener-Vacher SR. Vestibular disorders in children. Int J Audiol 2008; 47 (09) 578-583
• 8 Franco ES, Caetanaelli EB. Avaliação vestibular en crianças sem queixas auditivas e vestibulares, por meio da Vectoeletronistagmografia computadorizada. Arq Int Otorrinolaringol 2006; 10: 46-54
• 9 Riina N, Ilmari P, Kentala E. Vertigo and imbalance in children: a retrospective study in a Helsinki University otorhinolaryngology clinic. Arch Otolaryngol Head Neck Surg 2005; 131 (11) 996-1000
• 10 Niemensivu R, Kentala E, Wiener-Vacher S, Pyykkö I. Evaluation of vertiginous children. Eur Arch Otorhinolaryngol 2007; 264 (10) 1129-1135
• 11 Ralli G, Atturo F, de Filippis C. Idiopathic benign paroxysmal vertigo in children, a migraine precursor. Int J Pediatr Otorhinolaryngol 2009; 73 (Suppl. 01) S16-S18
• 12 O'Reilly RC, Morlet T, Nicholas BD. et al. Prevalence of vestibular and balance disorders in children. Otol Neurotol 2010; 31 (09) 1441-1444
• 13 Szirmai A. Vestibular disorders in childhood and adolescents. Eur Arch Otorhinolaryngol 2010; 267 (11) 1801-1804
• 14 Hamilton SS, Zhou G, Brodsky JR. Video head impulse testing (VHIT) in the pediatric population. Int J Pediatr Otorhinolaryngol 2015; 79 (08) 1283-1287
• 15 Bower CM, Cotton RT. The spectrum of vertigo in children. Arch Otolaryngol Head Neck Surg 1995; 121 (08) 911-915
• 16 Gladstone JP, Dodick DW. Revised 2004 International Classification of Headache Disorders: new headache types. Can J Neurol Sci 2004; 31 (03) 304-314
• 17 Furman JM, Marcus DA, Balaban CD. Migrainous vertigo: development of a pathogenetic model and structured diagnostic interview. Curr Opin Neurol 2003; 16 (01) 5-13
• 18 Lempert T, Olesen J, Furman J. et al. Vestibular migraine: diagnostic criteria. J Vestib Res 2012; 22 (04) 167-172
• 19 Langhagen T, Lehrer N, Borggraefe I, Heinen F, Jahn K. Vestibular migraine in children and adolescents: clinical findings and laboratory tests. Front Neurol 2015; 5: 292
• 20 Cutrer FM, Baloh RW. Migraine-associated dizziness. Headache 1992; 32 (06) 300-304
• 21 Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine?. J Neurol 1999; 246 (10) 883-892
• 22 Jahn K, Langhagen T, Heinen F. Vertigo and dizziness in children. Curr Opin Neurol 2015; 28 (01) 78-82
• 23 Kacperski J, Hershey AD. Preventive drugs in childhood and adolescent migraine. Curr Pain Headache Rep 2014; 18 (06) 422
• 24 Victor S, Ryan S. WITHDRAWN: Drugs for preventing migraine headaches in children. Cochrane Database Syst Rev 2014; 11 (07) CD002761
• 25 Richer L, Billinghurst L, Linsdell MA. et al. Drugs for the acute treatment of migraine in children and adolescents. Cochrane Database Syst Rev 2016; 4: CD005220