Protocolo de evaluación y valores de referencia de la ganancia del reflejo vestíbulo-ocular (RVO) en el plano horizontal registrado mediante el video-Head Impulse Test (v-HIT) en población pediátrica

Retamal, Sebastián Rivera; Díaz, Patricia Oyarzún; Marcotti, Anthony; Muñoz, Camila Gallardo; Espinoza, Melissa Richard; Araya, Valeria Sepúlveda; Rivera, Javiera Tapia

doi:10.1590/2317-1782/20202020076

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…More specifically, they found the most pronounced increase in VOR gain during early infancy until the age of 6 years old, after which a slower progression toward adultlike values was noted by the age of 16 years. The latter findings imply that progression in VOR gain mainly occurs early in life, which underlines the importance of age-appropriate normative data (Wiener-Vacher and Wiener 2017) and which can be the reason why previous vHIT studies, including older children, could not demonstrate significant age effects (Hamilton et al 2015;Janky et al 2015;Lehnen et al 2017;Retamal et al 2021;Ross and Helminski 2016). These major age effects in children below the age of 6 years may be related to maturational processes of the VOR cerebellar control (Wiener-Vacher and Wiener 2017).…”

Section: Normative Data and Age Effectsmentioning

confidence: 85%

“…Therefore, age-appropriate normative data are important to specify age trends across various response parameters of the pediatric vestibular test battery. Although several studies have previously published pediatric vestibular normative data and accompanying age trends, these studies mostly included older children, broad age categories, small sample sizes, and a limited number of vestibular tests, comprising large methodological differences (Kelsch et al 2006; Picciotti et al 2007; Valente 2007; Zagolski 2007; Casselbrant et al 2010; Maes et al 2014b; Hamilton et al 2015; Birdane et al 2016; Kastanioudakis et al 2016; Ross et al 2016; Lehnen et al 2017; Lotfi et al 2017; Siyamak et al 2017; Wiener-Vacher and Wiener 2017; Kuhn et al 2018; Bachmann et al 2018; Ahmad et al 2020; Retamal et al 2021). Even more important, pediatric vestibular normative data should be available when implementing vestibular screening in young patients to decide if referral for further assessment and intervention is needed, but without unnecessarily worrying parents.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Vestibular Assessment: Clinical Framework

et al. 2022

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Objectives: Although vestibular deficits can have severe repercussions on the early motor development in children, vestibular assessment in young children has not yet been routinely integrated in clinical practice and clear diagnostic criteria to detect early vestibular deficits are lacking. In young children, specific adjustments of the test protocol are needed, and normative data are age-dependent as the vestibular pathways mature through childhood. Therefore, this study aims to demonstrate the feasibility of an extensive age-dependent vestibular test battery, to provide pediatric normative data with the concurrent age trends, and to offer a clinical framework for pediatric vestibular testing. Design: This normative study included 133 healthy children below the age of 4 years (mean: 22 mo, standard deviation: 12.3 mo, range: 5–47 mo) without history of hearing loss or vestibular symptoms. Children were divided into four age categories: 38 children younger than 1 year old, 37 one-year olds, 33 two-year olds, and 25 three-year olds. Children younger than 3 years of age were examined with the video Head Impulse Test (vHIT) of the horizontal semicircular canals, cervical vestibular evoked myogenic potentials (cVEMP) with bone conduction stimuli, and the rotatory test at 0.16, 0.04, and 0.01 Hz. In 3-year old children, the vHIT of the vertical semicircular canals and ocular vestibular evoked myogenic potentials (oVEMP) using a minishaker were added to the protocol. Results: The horizontal vHIT appeared to be the most feasible test across age categories, except for children younger than 1-year old in which the success rate was the highest for the cVEMP. Success rates of the rotatory test varied the most across age categories. Age trends were found for the vHIT as the mean vestibulo-ocular reflex (VOR) gain increased significantly with age (r = 0.446, p < 0.001). Concerning the cVEMP, a significant increase with age was found for latency P1 (r = 0.420, p < 0.001), rectified interpeak amplitude P1-N1 (r = 0.574, p < 0.001), and averaged electromyographic (EMG) activity (r = 0.430, p < 0.001), whereas age trends for the latency N1 were less pronounced (r = 0.264, p = 0.004). Overall, the response parameters of the rotatory test did not show significant age effects (p > 0.01), except for the phase at 0.01 Hz (r = 0.578, p < 0.001). Based on the reported success rates and age-dependent normative vestibular data, straightforward cutoff criteria were proposed (vHIT VOR gain < 0.7, cVEMP rectified interpeak amplitude < 1.3, oVEMP interpeak amplitude < 10 µV) with accompanying clinical recommendations to diagnose early vestibular impairment. Conclusions. In this large cohort of typically developing children below the age of 4 years, the vHIT and cVEMP were the most feasible vestibular tests. Moreover, the age-dependent normative vestibular data could specify age trends in this group of young children. Finally, based on the current results and clinical experience of more than ten years at the Ghent University Hospital (...

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Section: Normative Data and Age Effectsmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Pediatric Vestibular Assessment: Clinical Framework

et al. 2022

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“…They also found no age-related differences among adolescents, consistent with our data for adolescents aged 11–16 years old [ 39 ]. When using the EyeSeeCam device, Retamal et al found no differences between their 5–10-year-old and 11–17-year-old groups, although this research was also limited by a particularly small sample size [ 40 ]. Surprisingly, and contrasting with our findings, they also found differences between the VOR gain values of the right and left horizontal canals [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Normative values for the video Head Impulse Test in children without otoneurologic symptoms and their evolution across childhood by gender

Rodríguez-Villalba

Caballero

2023

Eur Arch Otorhinolaryngol

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Purpose The video Head Impulse Test is routinely used to assess semicircular canal function in adults, but to date, pediatric reference values are scarce. This study aimed to explore the vestibulo-ocular reflex (VOR) in healthy children at different development stages and to compare the obtained gain values with reference to those in an adult population. Methods This prospective, single-center study recruited 187 children from among patients without otoneurological diseases, healthy relatives of these patients, and staff families from a tertiary hospital. Patients were divided into three groups by age: 3–6 years, 7–10 years, and 11–16 years. The vestibulo-ocular reflex was assessed by video Head Impulse Test, using a device with a high-speed infrared camera and accelerometer (EyeSeeCam®; Interacoustics, Denmark). Results We found a lower vestibulo-ocular reflex gain of both horizontal canals in the 3–6-year-old group when compared with the other age groups. No increasing trend was found in the horizontal canals from age 7–10 years to age 11–16 years, and no differences were found by sex. Conclusion Gain values in the horizontal canals increased with age until children reached age 7–10 years and matched the normal values for adults.

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“…This remote setup allows the vHIT to be used from 3 months of age, while the other systems can be used from 3 years of age [41]. It is important to mention that the gain values are lowest under 3 years of age, after which there is a rapid increase up to the age of 6 years, with a subsequent slower increase in vHIT gain up to 16 years [41,42]. It is worth mentioning that in some studies, the gain in vHIT was found to be stable from 4 to 18 years [43].…”

Section: Vestibular Function Test In the Diagnosis Of Children Vertigomentioning

confidence: 99%

Instrumental Assessment and Pharmacological Treatment of Migraine-Related Vertigo in Pediatric Age

Viola,

Scarpa,

Chiarella

et al. 2024

Audiology Research

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Background: The most frequent form of vertigo in pediatric age is represented by vertigo linked to migraine, with a prevalence of 32.7%. This group of pathologies has received a redefinition of the diagnostic criteria to adapt them to the pediatric age with a new classification of the clinical pictures. We have several kinds of problems with these conditions that often have a significant impact on patients’ and parents’ quality of life: the diagnostic approach involves different tools for the different age groups contained in the pediatric range; the treatment of this type of vertigo is not consolidated due to the limited availability of trials carried out on pediatric patients. Focusing on this topic, the aim of this review was to provide an update on the more recent clinical advances in the diagnosis and treatment of Vestibular Migraine (VM) in children. Methods: We searched the PubMed, Embase, and Cochrane library databases for articles published in English from January 2015 to April 2023. The secondary search included articles from reference lists, identified by the primary search. Records were first screened by title/abstract, and then full-text articles were retrieved for eligibility evaluation. The searches combined a range of key terms (“Pediatric” AND “Childhood” AND “dizziness” OR “vertigo” AND “vestibular”). Results: Migraine-related vertigo, in its most recent definitions and classifications, is the most frequent group of balance pathologies in pediatric age. The results from the various experiences present in the literature suggest a clinical approach to be integrated with the use of instrumental tests selected according to the age of the patient and the reliability of the results. Conclusion: Knowing the timeline of the applicability of vestibular tests and the information that can be obtained from them is fundamental for diagnostic accuracy. Therapy is strongly conditioned by the limited availability of pediatric trials and by the wide range it includes, from very young children to adolescents.

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Protocolo de evaluación y valores de referencia de la ganancia del reflejo vestíbulo-ocular (RVO) en el plano horizontal registrado mediante el video-Head Impulse Test (v-HIT) en población pediátrica

Cited by 4 publications

References 22 publications

Pediatric Vestibular Assessment: Clinical Framework

Pediatric Vestibular Assessment: Clinical Framework

Normative values for the video Head Impulse Test in children without otoneurologic symptoms and their evolution across childhood by gender

Instrumental Assessment and Pharmacological Treatment of Migraine-Related Vertigo in Pediatric Age

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