Clinical evaluation of vertigo in children

Abstract

Purpose: The purpose of this study was the clinical evaluation of vertigo in children. We focused on diseases which caused vertigo and the results of equilibrium examinations. Methods: The patient records of 40 children who underwent equilibrium examinations at the Department of Otolaryngology, Toyama University Hospital during 2002 to 2006 were retrospectively reviewed. The ages of the subjects ranged from 4 to 15 years. Patients were classified into three groups based on the site of the disease-peripheral vestibular disorders (Group I), central nervous system disorders (Group II) and the others (Group III). Equilibrium examinations consisted of recording of nystagmus under various stimulations using electronystagmography, stabilometry, and the Schellong test. Results: The number of patients in each group were 18 (Group I), 5 (Group II) and 17 (Group III). Eighty eight percent of Group I patients showed canal paresis (CP) including a case of bilateral CP in the caloric test. Group II included patients with serious diseases comprising spinocerebellar degeneration (n = 1), cerebellar tumor (n = 1) and cerebral infarction (n = 1). Patients in this group showed high abnormality in spontaneous nystagmus, eye tracking test, optokinetic nystagmus test, and stabilometry. The cerebellar tumor patient showed apparently weakened visual suppression to caloric nystagmus. Group III included patients with orthostatic dysregulation (n = 6), benign paroxysmal vertigo (n = 3) and migraine (n = 1). Eighty five percent of this group showed abnormal elevation of pulse rate in the Schellong test. Conclusions: 1) Peripheral vestibular disorders occupied more than central nervous system disorders. 2) Orthostatic dysregulation and benign paroxysmal vertigo seemed to be characteristic as causes of vertigo in children. 3) Completing the examinations was not so easy for the children. However, the importance of equilibrium examinations in children for diagnosis is the same as in adults.