Clinical Characteristics and Diagnostic Classification of Vertigo in Children

Abstract

BACKGROUND AND OBJECTIVES:Vertigo in children is relatively uncommon. The severity of vertigo in children varies from mild balance disturbance to true vertigo with obvious nystagmus and falling. There is not much concern about vertigo in children, thus only a few articles exist. The purpose of this study is to analyze the clinical characteristics and the results of audiological and vestibular evaluation, to classify the diagnostic causes of vertigo, and to provide the information about vertigo in children. MATERIALS AND METHODS: A total of 49 patients with vertigo or dizziness who visited Dizziness Clinic in the Department of Otolaryngology at Ajou University Hospital from January 1995 to December 2001 were included in this study. These patients were retrospectively reviewed based on clinical charts. The average age of the patients was 11.9 years, with a minimum of 3 years and a maximum of 15 years. All patients performed questionnaires and pure tone audiometries. Caloric tests and rotational tests were performed in 39 and 40 patients respectively. In selective cases, computed tomography, magnetic resonance imaging, electroencephalogram and hematologic test were performed. RESULTS: Migraine and benign paroxysmal vertigo of childhood (BPVC) were 32.7% and 20.4% in children with vertigo, respectively. Other causes were trauma, Meniere's disease, delayed endolymphatic hydrops, benign positional vertigo, cerebellopontine angle tumor, seizure, otitis media and unknown causes were 16.3%. Audiometry, caloric and rotational chair tests showed abnormal findings in 11 cases (22%), 5 cases (13%) and 30 cases (75%), respectively. CONCLUSION: Vertigo in children has different causes from adult vertigo, showing migraine and BPVC to be the most frequent causes. The evaluation of vertigo in children should include a complete history (questionnaire) and physical examination, an audiogram, and vestibular function tests. In selective cases, EEG, Hematologic evaluation and scanning of the brain or temporal bone should be performed.