Comprehensive Vestibular and Balance Testing in the Dizzy Pediatric Population

Abstract

Peripheral vestibular deficits and migraine disease account for most of the pathology in the pediatric population. With a multidisciplinary approach, diagnosis of the source of vertigo and imbalance is possible in most children.

Subjective visual vertical testing in children and adolescents

“…This is primarily a result of the low incidence of acute peripheral vestibulopathies in children. Some of the most common causes of peripheral vestibular loss in adults, such as Ménière's disease and vestibular schwannoma, are extremely rare in children . The majority of subjects in the PVL group had VN, which is also less common in the pediatric population.…”

“…Absolute values of SVV scores were used. Power analysis (power 5 0.80; a 5 .05) using predicted mean SVV scores of 1.1 6 standard deviation (SD) of 0.9 for non-PVL groups and 3.3 for the PVL group (2.5 SD above predicted non-PVL mean), based on a study of static SVV in 30 healthy adults, 24 yielded a projected sample size of four subjects per diagnosis group. Mean SVV scores for the PVL, BPPV, CV, NVD, and control groups were compared by one-way analysis of variance (ANOVA) with Tukey post hoc analysis of multiple comparisons.…”

“…The static SVV test does not involve rotation or stimulation of vertigo, which in our experience can sometimes be anxiety‐provoking factors that limit the use of other vestibular tests, such as the rotary chair and caloric tests, in children. Objective vestibular testing plays a particularly important role in the evaluation of dizziness in the pediatric population, where the history and examination are often limited, and the differential diagnosis is extensive . Vestibular tests that have been validated in adults require separate validation in children due to the varying maturity of the pediatric vestibular system …”

“…Objective vestibular testing plays a particularly important role in the evaluation of dizziness in the pediatric population, where the history and examination are often limited, and the differential diagnosis is extensive. 24 Vestibular tests that have been validated in adults require separate validation in children due to the varying maturity of the pediatric vestibular system. 25 The SVV test has not been studied in children with vestibular dysfunction.…”

Video head impulse testing (VHIT) in the pediatric population

“…This study's primary weakness is the relatively small number of patients, particularly within each age group, which is partially a result of the lower incidence of peripheral vestibular disorders in the pediatric population compared to adults [1,16,17]. A prospective, controlled study of VHIT in the pediatric population will help to better define the abnormal range of the test for children of different ages and to establish typical VHIT results in different peripheral vestibular disorders.…”