Korean J Otorhinolaryngol-Head Neck Surg.  2018 Sep;61(9):459-464. 10.3342/kjorl-hns.2017.00710.

Etiology and Clinical Characteristics of Pediatric Dizziness

• Lee HM
• Park J
• Lee B
• Lee KH
• Park SK
• Chang J

• KMID: 2436533
• DOI: http://doi.org/10.3342/kjorl-hns.2017.00710

Abstract

BACKGROUND AND OBJECTIVES
Dizziness is not uncommon in children. The etiology of dizziness varies according to different studies due to different methods of examination or characteristics of the dizziness center. To assess meaningful causes of dizziness in children, a multidisciplinary approach would be needed. The purpose of this study was to analyze the main pathologies associated with vertigo and dizziness in children, paying particular attention to recent diagnostic advances with a multidisciplinary approach.
SUBJECTS AND METHOD
A total of 73 children, aged between 4-18 years, who visited the Pediatric Dizziness Clinic of the University Hospital from January 2016 to June 2016 were included in this study. Medical records were reviewed retrospectively. All of the subjects were examined by history, questionnaires, physical examinations, electrocardiogram, hematologic tests, brain MRI scan, audiogram and vestibular function tests. Patients who had orthostatic symptoms additionally underwent a tilt table test, and in selective cases, a caloric and vestibular evoked myogenic potential tests as well.
RESULTS
Vestibular migraine (VM) and benign paroxysmal vertigo of childhood (BPVC) were found in 35.6% and 27.4% of the children with dizziness, respectively. The incidence of orthostatic hypotension and postural orthostatic tachycardia syndrome were 12.3% each, both of which are higher than other previous reports. Other causes were Meniere's disease, benign paroxysmal positional vertigo, vestibular neuritis and so on.
CONCLUSION
VM and BPVC were the most common causes of pediatric dizziness. Also, the incidence of orthostatic dizziness was rather high in pediatric population. The evaluation of dizziness in children should include a thorough check of history (questionnaire), neurotological examination, vestibular function tests and a tilt table test.

Keyword

Dizziness; Migraine; Orthostatic; Pediatric; Vestibular function test

MeSH Terms

Benign Paroxysmal Positional Vertigo
Brain
Child
Dizziness*
Electrocardiography
Hematologic Tests
Humans
Hypotension, Orthostatic
Incidence
Magnetic Resonance Imaging
Medical Records
Meniere Disease
Methods
Migraine Disorders
Pathology
Physical Examination
Postural Orthostatic Tachycardia Syndrome
Retrospective Studies
Tilt-Table Test
Vertigo
Vestibular Function Tests
Vestibular Neuronitis