Vertigo in children; with special reference to orthostatic dysregulation

Abstract

Dizziness is not an uncommon medical problem in children. When a child develops various physical symptoms in addition to dizziness, clinicians should include orthostatic dysregulation (OD) in their diagnosis. OD is composed of four different subsets, instantaneous orthostatic hypotension (INOH), postural tachycardia syndrome (POTS), neurally-mediated syncope and delayed orthostatic hypotension, and the former two are dominant. INOH involves dysfunction of the high-pressure system in the neural baroreflex pathway, and the low-pressure system in the case of POTS. Children with OD show a decrease in cerebral blood flow compared with unaffected children, and this might be associated with the mechanism responsible for dizziness. Further studies are anticipated in relation to OD and vestibular function.