Semin Hear 2018; 39(03): 321-333
DOI: 10.1055/s-0038-1666821
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Considerations for Testing and Treating Children with Central Vestibular Impairments

Jennifer B. Christy
1   Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama
› Author Affiliations
Further Information

Publication History

Publication Date:
20 July 2018 (online)

Abstract

This perspective explores common pediatric diagnoses that could present with central vestibular pathway dysfunction, leading to delays in motor development and postural control, and gaze instability. Specifically, the following diagnoses are considered: cerebral palsy, myelomeningocele, vestibular migraine, attention-deficit hyperactivity disorder, developmental coordination disorder, concussion, childhood cancer, congenital muscular torticollis, adolescent idiopathic scoliosis, and autism. Suggestions for clinical screening, vestibular function testing, and vestibular rehabilitation for children with these diagnoses are based on evidence for the efficacy of testing and interventions for children with peripheral vestibular hypofunction. More research is needed to explore peripheral and central vestibular function in children with these diagnoses. Testing and intervention methods may need to be modified to accommodate for the specific behavior and motor challenges that some children might present. Researchers should develop technology so that gaze stabilization exercises can be delivered in a fun, functional, and effective way.

 
  • References

  • 1 Kretch KS, Franchak JM, Adolph KE. Crawling and walking infants see the world differently. Child Dev 2014; 85 (04) 1503-1518
  • 2 Franchak JM, Adolph KE. Visually guided navigation: head-mounted eye-tracking of natural locomotion in children and adults. Vision Res 2010; 50 (24) 2766-2774
  • 3 Rine RM, Wiener-Vacher S. Evaluation and treatment of vestibular dysfunction in children. NeuroRehabilitation 2013; 32 (03) 507-518
  • 4 Tribukait A, Brantberg K, Bergenius J. Function of semicircular canals, utricles and saccules in deaf children. Acta Otolaryngol 2004; 124 (01) 41-48
  • 5 Cushing SL, Papsin BC, Rutka JA, James AL, Blaser SL, Gordon KA. Vestibular end-organ and balance deficits after meningitis and cochlear implantation in children correlate poorly with functional outcome. Otol Neurotol 2009; 30 (04) 488-495
  • 6 Bernard S, Wiener-Vacher S, Van Den Abbeele T, Teissier N. Vestibular disorders in children with congenital cytomegalovirus infection. Pediatrics 2015; 136 (04) e887-e895
  • 7 Rosenbaum P, Paneth N, Leviton A. , et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109: 8-14
  • 8 Picciotti PM, Fiorita A, Calò L. , et al. Vestibular evoked myogenic potentials in children affected by myelomeningocele. Childs Nerv Syst 2012; 28 (10) 1761-1765
  • 9 Camet ML, Hayashi SS, Sinks BC. , et al. Determining the prevalence of vestibular screening failures in pediatric cancer patients whose therapies include radiation to the head/neck and platin-based therapies: a pilot study. Pediatr Blood Cancer 2018; 65 (06) e26992
  • 10 Rine RM, Dannenbaum E, Szabo J. 2015 section on pediatrics knowledge translation lecture: pediatric vestibular-related impairments. Pediatr Phys Ther 2016; 28 (01) 2-6
  • 11 Rine RM, Braswell J, Fisher D, Joyce K, Kalar K, Shaffer M. Improvement of motor development and postural control following intervention in children with sensorineural hearing loss and vestibular impairment. Int J Pediatr Otorhinolaryngol 2004; 68 (09) 1141-1148
  • 12 Rine RM, Cornwall G, Gan K. , et al. Evidence of progressive delay of motor development in children with sensorineural hearing loss and concurrent vestibular dysfunction. Percept Mot Skills 2000; 90 (3, Pt 2): 1101-1112
  • 13 Christy JB, Payne J, Azuero A, Formby C. Reliability and diagnostic accuracy of clinical tests of vestibular function for children. Pediatr Phys Ther 2014; 26 (02) 180-189
  • 14 Rine RM, Braswell J. A clinical test of dynamic visual acuity for children. Int J Pediatr Otorhinolaryngol 2003; 67 (11) 1195-1201
  • 15 Braswell J, Rine RM. Preliminary evidence of improved gaze stability following exercise in two children with vestibular hypofunction. Int J Pediatr Otorhinolaryngol 2006; 70 (11) 1967-1973
  • 16 Braswell J, Rine RM. Evidence that vestibular hypofunction affects reading acuity in children. Int J Pediatr Otorhinolaryngol 2006; 70 (11) 1957-1965
  • 17 Hall CD, Herdman SJ, Whitney SL. , et al. Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: from the American Physical Therapy Association Neurology Section. J Neurol Phys Ther 2016; 40 (02) 124-155
  • 18 Pavlou M, Whitney S, Alkathiry AA. , et al. The pediatric vestibular symptom questionnaire: a validation study. J Pediatr 2016; 168: 171-177.e1
  • 19 McCaslin DL, Jacobson GP, Lambert W, English LN, Kemph AJ. The development of the Vanderbilt pediatric dizziness handicap inventory for patient caregivers (DHI-PC). Int J Pediatr Otorhinolaryngol 2015; 79 (10) 1662-1666
  • 20 Pavlou M, Whitney SL, Alkathiry AA. , et al. Visually induced dizziness in children and validation of the pediatric visually induced dizziness questionnaire. Front Neurol 2017; 8: 656
  • 21 Christy JB, Rine R. The Questionnaire for dizziness, eye and balance (Q-DEB) function for children and adolescents. Pediatr Phys Ther 2017; 29 (01) E12
  • 22 Cullen KE. Physiology of central pathways. Handb Clin Neurol 2016; 137: 17-40
  • 23 Novak I, McIntyre S, Morgan C. , et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol 2013; 55 (10) 885-910
  • 24 Boot FH, Pel JJ, van der Steen J, Evenhuis HM. Cerebral visual impairment: which perceptive visual dysfunctions can be expected in children with brain damage? A systematic review. Res Dev Disabil 2010; 31 (06) 1149-1159
  • 25 Barela JA, Focks GM, Hilgeholt T, Barela AM, Carvalho RdeP, Savelsbergh GJ. Perception-action and adaptation in postural control of children and adolescents with cerebral palsy. Res Dev Disabil 2011; 32 (06) 2075-2083
  • 26 Fazzi E, Signorini SG, LA Piana R. , et al. Neuro-ophthalmological disorders in cerebral palsy: ophthalmological, oculomotor, and visual aspects. Dev Med Child Neurol 2012; 54 (08) 730-736
  • 27 Lew H, Lee HS, Lee JY, Song J, Min K, Kim M. Possible linkage between visual and motor development in children with cerebral palsy. Pediatr Neurol 2015; 52 (03) 338-343.e1
  • 28 Park MJ, Yoo YJ, Chung CY, Hwang JM. Ocular findings in patients with spastic type cerebral palsy. BMC Ophthalmol 2016; 16 (01) 195
  • 29 Guzzetta A, Mercuri E, Cioni G. Visual disorders in children with brain lesions: 2. Visual impairment associated with cerebral palsy. Eur J Paediatr Neurol 2001; 5 (03) 115-119
  • 30 Ghasia F, Brunstrom J, Gordon M, Tychsen L. Frequency and severity of visual sensory and motor deficits in children with cerebral palsy: gross motor function classification scale. Invest Ophthalmol Vis Sci 2008; 49 (02) 572-580
  • 31 Saavedra S, Joshi A, Woollacott M, van Donkelaar P. Eye hand coordination in children with cerebral palsy. Exp Brain Res 2009; 192 (02) 155-165
  • 32 Porro G, van der Linden D, van Nieuwenhuizen O, Wittebol-Post D. Role of visual dysfunction in postural control in children with cerebral palsy. Neural Plast 2005; 12 (2-3): 205-210 , discussion 263–272
  • 33 Saavedra S, Woollacott M, van Donkelaar P. Head stability during quiet sitting in children with cerebral palsy: effect of vision and trunk support. Exp Brain Res 2010; 201 (01) 13-23
  • 34 Bartonek A, Lidbeck CM, Gutierrez-Farewik EM. Influence of external visual focus on gait in children with bilateral cerebral palsy. Pediatr Phys Ther 2016; 28 (04) 393-399
  • 35 Akbarfahimi NHS, Rassafiani M, Rezazadeh N, Shahshahani F, Ghomsheh T, Karimlou M. Assessment of the saccular function in children with spastic cerebral palsy. Neurophysiology 2016; 48 (02) 9
  • 36 Tramontano M, Medici A, Iosa M. , et al. The effect of vestibular stimulation on motor functions of children with cerebral palsy. Mot Contr 2017; 21 (03) 299-311
  • 37 Naya Gálvez MJ, Fraile Rodrigo JJ, Liesa RF. , et al. Otorhinolaryngologic manifestations in Chiari malformation. Am J Otolaryngol 2002; 23 (02) 99-104
  • 38 Langhagen T, Landgraf MN, Huppert D, Heinen F, Jahn K. Vestibular migraine in children and adolescents. Curr Pain Headache Rep 2016; 20 (12) 67
  • 39 Kacperski J, Bazarsky A. New developments in the prophylactic drug treatment of pediatric migraine: what is new in 2017 and where does it leave us?. Curr Pain Headache Rep 2017; 21 (08) 38
  • 40 Al-Twaijri WA, Shevell MI. Pediatric migraine equivalents: occurrence and clinical features in practice. Pediatr Neurol 2002; 26 (05) 365-368
  • 41 Chang CH, Young YH. Caloric and vestibular evoked myogenic potential tests in evaluating children with benign paroxysmal vertigo. Int J Pediatr Otorhinolaryngol 2007; 71 (03) 495-499
  • 42 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
  • 43 Marcelli V, Furia T, Marciano E. Vestibular pathways involvement in children with migraine: a neuro-otological study. Headache 2010; 50 (01) 71-76
  • 44 Ashish G, Augustine AM, Tyagi AK, Lepcha A, Balraj A. Subjective visual vertical and horizontal in vestibular migraine. J Int Adv Otol 2017; 13 (02) 254-258
  • 45 O'Reilly R, Morlet T, Pazuniak M, Greywood J, Levi J. Vestibular and balance testing in childhood migraine. Laryngoscope 2012; 122 (Suppl. 04) S93-S94
  • 46 Langhagen T, Schroeder AS, Rettinger N, Borggraefe I, Jahn K. Migraine-related vertigo and somatoform vertigo frequently occur in children and are often associated. Neuropediatrics 2013; 44 (01) 55-58
  • 47 Danielson ML, Bitsko RH, Ghandour RM, Holbrook JR, Kogan MD, Blumberg SJ. Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. J Clin Child Adolesc Psychol 2018; 47 (02) 199-212
  • 48 Salem H, Vivas D, Cao F, Kazimi IF, Teixeira AL, Zeni CP. ADHD is associated with migraine: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2018; 27 (03) 267-277
  • 49 Lotfi Y, Rezazadeh N, Moossavi A. , et al. Rotational and collic vestibular-evoked myogenic potential testing in normal developing children and children with combined attention deficit/hyperactivity disorder. Ear Hear 2017; 38 (06) e352-e358
  • 50 Lotfi Y, Rezazadeh N, Moossavi A. , et al. Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment. Auris Nasus Larynx 2017; 44 (06) 700-707
  • 51 Isaac V, Olmedo D, Aboitiz F, Delano PH. Altered cervical vestibular-evoked myogenic potential in children with attention deficit and hyperactivity disorder. Front Neurol 2017; 8: 90
  • 52 Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol 2011; 7 (04) 184-196
  • 53 Zwicker JG, Missiuna C, Harris SR, Boyd LA. Developmental coordination disorder: a pilot diffusion tensor imaging study. Pediatr Neurol 2012; 46 (03) 162-167
  • 54 Fong SS, Ng SS, Yiu BP. Slowed muscle force production and sensory organization deficits contribute to altered postural control strategies in children with developmental coordination disorder. Res Dev Disabil 2013; 34 (09) 3040-3048
  • 55 Fong SS, Tsang WW, Ng GY. Altered postural control strategies and sensory organization in children with developmental coordination disorder. Hum Mov Sci 2012; 31 (05) 1317-1327
  • 56 Fong SS, Chung JW, Chow LP, Ma AW, Tsang WW. Differential effect of Taekwondo training on knee muscle strength and reactive and static balance control in children with developmental coordination disorder: a randomized controlled trial. Res Dev Disabil 2013; 34 (05) 1446-1455
  • 57 Fong SS, Guo X, Liu KP. , et al. Task-specific balance training improves the sensory organisation of balance control in children with developmental coordination disorder: a randomised controlled trial. Sci Rep 2016; 6: 20945
  • 58 Carrick FR, Clark JF, Pagnacco G. , et al. Head-eye vestibular motion therapy affects the mental and physical health of severe chronic postconcussion patients. Front Neurol 2017; 8: 414
  • 59 Swanson MW, Weise KK, Dreer LE. , et al. Academic difficulty and vision symptoms in children with concussion. Optom Vis Sci 2017; 94 (01) 60-67
  • 60 Heinmiller L, Gunton KB. A review of the current practice in diagnosis and management of visual complaints associated with concussion and postconcussion syndrome. Curr Opin Ophthalmol 2016; 27 (05) 407-412
  • 61 Leddy JJ, Baker JG, Willer B. Active rehabilitation of concussion and post-concussion syndrome. Phys Med Rehabil Clin N Am 2016; 27 (02) 437-454
  • 62 Master CL, Master SR, Wiebe DJ. , et al. Vision and vestibular system dysfunction predicts prolonged concussion recovery in children. Clin J Sport Med 2018; 28 (02) 139-145
  • 63 McDevitt J, Appiah-Kubi KO, Tierney R, Wright WG. Vestibular and oculomotor assessments may increase accuracy of subacute concussion assessment. Int J Sports Med 2016; 37 (09) 738-747
  • 64 Wright WG, Tierney RT, McDevitt J. Visual-vestibular processing deficits in mild traumatic brain injury. J Vestib Res 2017; 27 (01) 27-37
  • 65 Schneider KJ, Leddy JJ, Guskiewicz KM. , et al. Rest and treatment/rehabilitation following sport-related concussion: a systematic review. Br J Sports Med 2017; 51 (12) 930-934
  • 66 Alshehri MM, Sparto PJ, Furman JM. , et al. The usefulness of the video head impulse test in children and adults post-concussion. J Vestib Res 2016; 26 (5-6): 439-446
  • 67 Heick JD, Bay C, Dompier TP, Valovich McLeod TC. Relationships among common vision and vestibular tests in healthy recreational athletes. Int J Sports Phys Ther 2017; 12 (04) 581-591
  • 68 Marquez C, Lininger M, Raab S. Establishing normative change values in visual acuity loss during the dynamic visual acuity test. Int J Sports Phys Ther 2017; 12 (02) 227-232
  • 69 Patterson JN, Murphy AM, Honaker JA. Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes. J Am Acad Audiol 2017; 28 (01) 36-45
  • 70 Frühwald MC, Rutkowski S. Tumors of the central nervous system in children and adolescents. Dtsch Arztebl Int 2011; 108 (22) 390-397
  • 71 Kaplan SL, Coulter C, Fetters L. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the Section on Pediatrics of the American Physical Therapy Association. Pediatr Phys Ther 2013; 25 (04) 348-394
  • 72 Bronstein AM, Rudge P. Vestibular involvement in spasmodic torticollis. J Neurol Neurosurg Psychiatry 1986; 49 (03) 290-295
  • 73 Münchau A, Bronstein AM. Role of the vestibular system in the pathophysiology of spasmodic torticollis. J Neurol Neurosurg Psychiatry 2001; 71 (03) 285-288
  • 74 Hallberg A, Standring RT, Ahsan S. Congenital torticollis and saccular dysfunction: a case report. JAMA Otolaryngol Head Neck Surg 2013; 139 (06) 639-642
  • 75 Cakrt O, Slabý K, Viktorinová L, Kolář P, Jeřábek J. Subjective visual vertical in patients with idiopathic scoliosis. J Vestib Res 2011; 21 (03) 161-165
  • 76 Haumont T, Gauchard GC, Lascombes P, Perrin PP. Postural instability in early-stage idiopathic scoliosis in adolescent girls. Spine 2011; 36 (13) E847-E854
  • 77 Hitier M, Hamon M, Denise P. , et al. Lateral semicircular canal asymmetry in idiopathic scoliosis: an early link between biomechanical, hormonal and neurosensory theories?. PLoS One 2015; 10 (07) e0131120
  • 78 Lambert FM, Malinvaud D, Gratacap M, Straka H, Vidal PP. Restricted neural plasticity in vestibulospinal pathways after unilateral labyrinthectomy as the origin for scoliotic deformations. J Neurosci 2013; 33 (16) 6845-6856
  • 79 Catanzariti JF, Agnani O, Guyot MA, Wlodyka-Demaille S, Khenioui H, Donze C. Does adolescent idiopathic scoliosis relate to vestibular disorders? A systematic review. Ann Phys Rehabil Med 2014; 57 (6-7): 465-479
  • 80 Pialasse JP, Mercier P, Descarreaux M, Simoneau M. A procedure to detect abnormal sensorimotor control in adolescents with idiopathic scoliosis. Gait Posture 2017; 57: 124-129
  • 81 Zwergal A, Rettinger N, Frenzel C, Dieterich M, Brandt T, Strupp M. A bucket of static vestibular function. Neurology 2009; 72 (19) 1689-1692
  • 82 Bhat AN, Landa RJ, Galloway JC. Current perspectives on motor functioning in infants, children, and adults with autism spectrum disorders. Phys Ther 2011; 91 (07) 1116-1129
  • 83 Carson TB, Wilkes BJ, Patel K. , et al. Vestibulo-ocular reflex function in children with high-functioning autism spectrum disorders. Autism Res 2017; 10 (02) 251-266
  • 84 Furman JM, Osorio MJ, Minshew NJ. Visual and vestibular induced eye movements in verbal children and adults with autism. Autism Res 2015; 8 (06) 658-667
  • 85 Smoot Reinert S, Jackson K, Bigelow K. Using posturography to examine the immediate effects of vestibular therapy for children with autism spectrum disorders: a feasibility study. Phys Occup Ther Pediatr 2015; 35 (04) 365-380
  • 86 Scherer M, Migliaccio AA, Schubert MC. Effect of vestibular rehabilitation on passive dynamic visual acuity. J Vestib Res 2008; 18 (2-3): 147-157
  • 87 Schubert MC, Migliaccio AA, Clendaniel RA, Allak A, Carey JP. Mechanism of dynamic visual acuity recovery with vestibular rehabilitation. Arch Phys Med Rehabil 2008; 89 (03) 500-507
  • 88 Brown KE, Whitney SL, Marchetti GF, Wrisley DM, Furman JM. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil 2006; 87 (01) 76-81