Pediatric Vestibular Evaluation with Harmonic Acceleration

Abstract

A group of 101 otologically normal infants and children were evaluated with low-frequency harmonic acceleration (HA) to determine the feasibility of use of this procedure in evaluation of vestibular function in a pediatric population. Ninety-six of the subjects were successfully tested and normative data are presented. A maturational trend was noted (in the presence of nystagmus) in subjects up to 10 months of age and in the phase-lag measurement up to approximately 4 years of age.

Benign paroxysmal vertigo of childhood: A review of the literature

“…The evaluation must take into account the developmental stage of all the anatomical relationships of the ear and vestibular system (Eustachian tube, temporomandibular joint, facial nerve, oculomotor nerves and ocular pathways, etc) (42,43), as well as the maturation of postural control (2,3). Vestibular disorders due to either congenital anomalies or trauma may result in postural head tilt, delayed postural control and incoordination (3,(43)(44)(45).…”

Assessment: Vestibular testing techniques in adults and children [RETIRED]

“…Caloric and rotational testing have been studied in normal, dizzy, and hearing-impaired children. 95,99,100,[107][108][109]111 In summary, the majority of normal children demonstrate vestibular responses to caloric and rotational stimuli by age 2 months. By age 10 months, the absence of VOR responses can be considered abnormal.…”

“…Some vestibular disorders recognized only in adulthood actually had their origins in childhood, 94 and vestibular dysfunction may result in delayed postural control, episodic vertigo, incoordination, and paroxysmal head tilt in young children. [95][96][97] In small children, balance is assessed by a series of clinical examination tests of postural control. 98 However, poor postural control is not specific for vestibular dysfunction.…”

“…By age 10 months, the absence of VOR responses can be considered abnormal. 95,99,101,102,[107][108][109][111][112][113] Ice water and rotational vestibular responses can sometimes be obtained in neonates, but lack of a response in a child less than 6 months of age is not necessarily abnormal. 95,100 Technical modifications.…”

“…If bilateral vestibular loss is of concern, a rotational chair test is preferred, and was successfully completed in 95% of children between 3 and 10 years of age in one study. 95 Clinical uses. Vestibular responses have been studied in children with reading difficulty, 108 post-traumatic syndrome, 115 otitis media, 116,117 fetal-alcohol syndrome, 118 serous otitis media, 119 the CHARGE (Coloboma [eyes], Heart defects, Atresia of the choanae, Retarded growth, Genital hypoplasia, Ear anomalies) association, 120 learning disabilities, and dyslexia.…”