Dizziness in childhood is not an infrequent symptom. Accurate history taking and close co-operation between otologist, paediatrician and neurologist are necessary in the approach to the dizzy child. Most cases of childhood dizziness settle in time and investigations should be carefully selected; those with severe and persistent dizziness or ataxia should be thoroughly investigated including: EEG, ENG, calorics and CT scan. The conditions causing dizziness in children are discussed and are illustrated with case histories from our series of 27 children. Dizziness of unknown aetiology, serous otitis media and benign paroxysmal vertigo were the most common diagnostic labels applied to our patients. Treatment is rarely necessary but dimenhydrinate or a labyrinthine sedative in those with troublesome vertigo, or the adjustment of the medical regime in those epileptics on phenytoin, may be beneficial. Surgical intervention is only required in those with an operable lesion.

A sequential double blind cross-over trial of tocainide hydrochloride, an oral analogue of lignocaine, is reported. The dosage of tocainide hydrochloride ranged from 200-600 mg daily. Of the 32 patients who completed the trial, 1 had complete relief and 2 had partial relief of their tinnitus whilst taking tocainide. An increased incidence of side-effects in patients taking tocainide was noted, in particular, headache, dizziness, nausea and skin rashes.

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Two cases of laryngeal chemodectoma are presented. They illustrate the differences between benign and malignant varieties of this tumour. The problem of differentiating between these two types at an early stage is discussed and a possible treatment policy is presented.

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A double-blind crossover controlled trial assessing the use of intravenous lignocaine in the treatment of tinnitus is reported. Possible modes of action of the drug are suggested. It is shown that intravenous lignocaine is effective in reducing tinnitus, although duration of such effect is short. Consistently effective oral preparations to control tinnitus are yet to be described.

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