Dizziness and Balance Problems in Children

Dasgupta, Soumit; Mandalà, Marco; Salerni, Lorenzo; Crunkhorn, Rosa; Ratnayake, Sudhira

doi:10.1007/s11940-020-0615-9

Cited by 12 publications

(11 citation statements)

References 62 publications

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“…Evidence about the HIMP paradigm in children is limited but emerging ( 9 ). The procedure can be safely and effectively executed in children, but the outcome norms may be different ( 21 ) and indeed every individual laboratory should have their own norms ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Finer aspects of the HIMP protocol beyond measuring the adult peripheral vestibular system are emerging, for example the HIMP in central neurological lesions ( 8 ). In the pediatric population, the video head impulse test with the HIMP protocol is gradually emerging but even then, it is limited ( 9 ). It is a safe and user-friendly procedure to perform in children with good information about canal function but requires a high skill set.…”

Section: Introductionmentioning

confidence: 99%

“…The SHIMP paradigm has hardly been studied in children. The physiology/pathology and behavior of pediatric and adult vestibular function in health and disease differ from each other ( 9 ). Cerebral plasticity in children ensures robust compensation, and thus, it is important to figure out how SHIMP will behave in children.…”

Section: Introductionmentioning

confidence: 99%

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Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Dasgupta,

Crunkhorn,

Wong

et al. 2024

Front. Neurol.

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The suppression head impulse paradigm (SHIMP) involves suppression of the vestibulo-ocular reflex (VOR) and anticompensatory saccades generated thereof. SHIMP is gaining importance to understand vestibular compensation with its different parameters (VOR gain/peak saccadic velocity PSV/latency of saccades). SHIMP studies are emerging in adults, but pediatric studies have hardly been performed. This study is a retrospective case note audit over a period of 2 months in a tertiary pediatric vestibular center in the United Kingdom to investigate whether SHIMP is safe/robust to be used in children conforming to existing standards/norms in normal children and whether it yields any meaningful inferences in pediatric vestibular hypofunction. This is the largest pediatric SHIMP study to date. A total of 44 referred children (6–18 years, female children>male children) with a range of complaints from dizziness, imbalance, motor incoordination, postural instability, and hearing loss were included, and their SHIMP parameters were measured. All children underwent comprehensive functional/objective audiovestibular assessments. Two groups were defined—Group A with normal vestibular function and Group B with abnormal vestibular function. The normal population showed an average SHIMP VOR gain of 0.98+/−0.08 and latency of overt saccades at 215.68+/–46.16 milliseconds agreeing with published evidence. The PSV of overt saccades was 315.39+/−56.30/s, and there was a gain asymmetry of 7.42+/−4.68 between the sides. Statistically significant differences with moderate/large effect sizes were observed between the groups in terms of VOR gain and PSV but not in saccade latencies. Covert saccades were rare in SHIMP, while overt saccades were observed in 100% of children. VOR gain difference between the head impulse paradigm (HIMP) and the SHIMP was significant as well. We observed statistically significant differences in side asymmetry of VOR gain between the groups. Furthermore, we identified a group of children with cerebellar lesions where overt saccades in SHIMP were rather low in number. Further research is recommended to investigate pediatric PSV, asymmetry, and inability to generate overt saccades that may suggest useful means to assess compensation and central function. We conclude that SHIMP yields valuable information and is a safe, easy to perform, and a reliable test that should be used in children to supplement HIMP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Dasgupta,

Crunkhorn,

Wong

et al. 2024

Front. Neurol.

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“…There are characteristic symptoms of the third window effect. However, in children, these may be difficult to elicit and, indeed, obtaining this history is an art in itself driven by several behavioral factors in the child (32). Thus, eliciting this history is often surrogate and dependant on carers or parents who usually are quite reliable and astute to observe hearing and vestibular behavior in the children.…”

Section: Anamnesismentioning

confidence: 99%

Audiovestibular Quantification in Rare Third Window Disorders in Children

et al. 2020

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“…An estimated one third of the US population experience disorders of balance and/or vestibular function [4]. Adults and children are both impacted [9], yet evidence suggests symptoms from vestibular pathology are more common in women than men, and more common in older versus younger individuals [11]. According to the National Ambulatory Medical Care Survey (NAMCS) [7], dizziness or vertigo represent one of the top ten principal reasons for emergency department visits involving older adults, with women accounting for almost twice as many visits as men.…”

Section: Introductionmentioning

confidence: 99%

Regional differences in patient-reported outcomes as a proxy of healthcare practices for Americans living with vestibular symptoms

Souza

Grove

Gerend³

et al. 2022

VES

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BACKGROUND: Geographical location is known to affect health outcomes; however, evidence regarding whether location affects healthcare for persons suspected to have vestibular dysfunction is lacking. OBJECTIVE: To investigate whether location affects healthcare seeking and outcomes for adults with symptoms of vestibular pathology. METHODS: We assessed for regional disparities associated with demographics, diagnosis, chronological factors, and financial expenditures from Americans who participated in the Vestibular Disorders Association registry (N = 905, 57.4±12.5 years, 82.7% female, 94.8% White, and 8.1% Hispanic or Latino). Respondents were grouped per geographical regions defined by the United States Census Bureau. RESULTS: There were no significant between-region differences for age (p = 0.10), sex (p = 0.78), or ethnicity (p = 0.24). There were more Asian respondents in the West versus the Midwest (p = 0.05) and more Black respondents in the South versus the West (p = 0.05). The time to first seek care was shorter in the Northeast (17.3 [SD = 49.5] weeks) versus the South (42.4 [SD = 83.7] weeks), p = 0.015. The time from the first healthcare visit to receiving a final diagnosis was shorter in the Northeast (46.5 [SD = 75.4] weeks) versus the South (68.9 [SD = 89.7] weeks), p = 0.015. Compared to the Midwest, fewer respondents in the Northeast reported “no” out-of-pocket financial impact, p = 0.039. CONCLUSIONS: Geographical location affects healthcare seeking and outcomes for persons suspected to have vestibular dysfunction.

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Dizziness and Balance Problems in Children

Cited by 12 publications

References 62 publications

Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Audiovestibular Quantification in Rare Third Window Disorders in Children

Regional differences in patient-reported outcomes as a proxy of healthcare practices for Americans living with vestibular symptoms

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