Balance disorders in childhood: Main etiologies according to age. Usefulness of the video head impulse test

Sommerfleck, Patricia Alejandra; Macchi, M E González; Weinschelbaum, Romina; Bagge, Maximiliano Damián De; Bernáldez, Patricia Cristina; Carmona, Sérgio

doi:10.1016/j.ijporl.2016.06.020

Cited by 37 publications

(31 citation statements)

References 20 publications

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“…This prevalence rate is highly variable depending on the centers (6-20%). 10,11,14 BPPV (i.e., brief, intense, and positional vertigo) is the most frequent etiology of acute vertigo in adults, but it is rare in children (1.2% in our series) and always occurs in the context of cranial trauma after a fall or a road accident. The characteristics are the same in children and in adults: vertigo occurring during a change of position (e.g., Hallpike-Dix position) with adaptable and fatigable geotropic nystagmus (i.e., rapid phase of the nystagmus beating toward the ground) occurring with a latency.…”

Section: Posttraumatic Vertigomentioning

confidence: 71%

“…There is consensus in the literature that the most common diagnoses in children with vertigo, dizziness, and headache is vestibular migraine usually in 20 to 28% of cases 11,13,14,27 and even in some studies 40 and 60%. 5,9 In our data, the diagnosis of migraine was retained in 15.6% of the children with normal vestibular function assessment and normal neurological examination.…”

Section: Headache and Vertigo Migraine Equivalent Vestibular Migrainementioning

confidence: 99%

“…Previous studies have reported the distribution of the various diagnoses found for BDs in pediatric populations. [5][6][7][8][9][10][11][12][13][14] In these articles, the etiologies of dizziness and BD in children are quite similar to those of adults with some exceptions. In the authors' clinical experience, migrainous equivalents are (as in adults) the most frequent etiology for dizzy sensations in children (17-40%).…”

mentioning

confidence: 99%

“…Since only few centers perform vestibular testing in young children, few publications have evaluated the prevalence of VI on a large pediatric population with a wide range of ages. For example, Sommerfleck et al 14 used videonystagmography (VNG) and the video head impulse test (VHIT) and found the prevalence of VI in children referred for BDs was 20% (n ¼ 206, ages 1-18 years). For hearing loss, the prevalence of VI is reportedly 50 to 70% and is independent of the severity of the hearing loss 16,17 but highly related to the etiology of the hearing loss.…”

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confidence: 99%

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Epidemiology of Vestibular Impairments in a Pediatric Population

2018

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The purpose of this study was to report the prevalence of vestibular impairment (VI) in children ( = 2,528) referred for complete vestibular testing because of balance disorders (BD) or hearing loss (H). A VI was shown in 51.5% of the children tested (1,304/2,528). For BD (e.g., vertigo, dizziness, instability, delay in posturomotor development), VI was found in 36.5% ( = 379/1,037). The most frequent causes of BD with VI included inner ear malformation (13.5%), delay in posturomotor development (13.4%), hearing loss revealed with vertigo (3.9%), trauma (3.9%), vestibular neuritis (3.3%), meningitis (2.5%), Meniere-like syndrome (1.1%), BPPV posttrauma (1%), labyrinthitis (0.4%), and unknown etiology (19.6%). Normal responses to the complete battery of tests ( = 658, 63.5%) excluded a vestibular origin to BD, leading to other diagnoses: principally migraine (15.6%), ophthalmological disorders (15.1%), neurological disorders (including delay in posturomotor development; 14.4%), orthostatic hypotension, or somatoform dizziness (<1%). Of the children referred for hearing loss ( = 1,491), 68.5% were tested without cochlear implantation (CI; = 1,022). In this group, 54.5% presented with VI ( = 557). This was mostly found in cytomegalovirus infection, inner ear malformation, and genetic syndromes. Profound hearing loss candidates for cochlear implants had complete bilateral vestibular loss in 20% and delay in posturomotor development, and 80% had partial or normal vestibular function and normal posturomotor development. VI was found after CI in 50% on the side of the implant (partial in 41% and complete in 9%). VI is present in 36.5% of children referred to our center for BDs and 54.5% for hearing loss. Vestibular testing permits ruling out peripheral VI and hence seeking other causes for BDs such as migraine and ophthalmological disorders and also helps lower the risk of inducing bilateral complete vestibular loss in CI protocols.

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Section: Posttraumatic Vertigomentioning

confidence: 71%

Section: Headache and Vertigo Migraine Equivalent Vestibular Migrainementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Epidemiology of Vestibular Impairments in a Pediatric Population

2018

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“…Until recently, objective measurement of the defective VOR in the HIT has been possible only with a complex method limited to research laboratories: scleral search coils [90]. There are now several commercially available, video-based systems (most head-mounted, one wall-mounted) [91–93], with which a clinician can measure the VOR from each of the six canals in a reasonably co-operative adult or child [94, 95] in about 10 min. Audiologists [96] and physiotherapists [97] are already doing so.…”

Section: Video Head Impulse Testingmentioning

confidence: 99%

Neuro-otology- some recent clinical advances

2016

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Multifactorial Characteristics of Pediatric Dizziness and Imbalance

et al. 2020

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Objectives: To examine the relative prevalence of individual diagnoses in children and adolescents presenting with dizziness and/or imbalance, and to assess the proportion of patients assigned multiple contributing diagnoses. Study Design: Retrospective cohort study. Methods: We retrospectively reviewed our internal database of all patients seen at our pediatric vestibular program between January 2012 and March 2019 to determine the incidence of common diagnoses and groups of diagnoses for patients ages 21 or younger. Results: One thousand twenty-one patients were included with a mean age of 12.5 AE 4.9 years (range: 9 months-21 years). Of this total, 624 patients were female and 397 were male. Common diagnoses included vestibular migraine (VM; 35.0%), benign paroxysmal positional vertigo (BPPV; 21.6%), primary dysautonomia (15.7%), anxiety disorder (13.5%), and persistent postural perceptual dizziness (PPPD; 11.2%). A high proportion of patients (44.4%) received multiple contributing diagnoses. VM was frequently diagnosed with BPPV or PPPD, and 22 patients were diagnosed with all three concurrently. Conclusion: The causes of dizziness and imbalance in the pediatric population are diverse, and many patients have multiple diagnoses that are often interrelated. It is important that providers recognize that the causes of vestibular symptoms in children and adolescents may be multifactorial and may span across multiple specialties.

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Balance disorders in childhood: Main etiologies according to age. Usefulness of the video head impulse test

Cited by 37 publications

References 20 publications

Epidemiology of Vestibular Impairments in a Pediatric Population

Epidemiology of Vestibular Impairments in a Pediatric Population

Neuro-otology- some recent clinical advances

Multifactorial Characteristics of Pediatric Dizziness and Imbalance

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