Retrospective review of children with vertigo: a 3-year experience

Year 2020, Volume: 6 Issue: 5, 449 - 456, 04.09.2020

Muhammet Furkan Korkmaz Arzu Ekici

https://doi.org/10.18621/eurj.630613

Cited By: 2

Abstract

Objectives:
To
evaluate the age, sex, accompanying symptoms, etiologic factors and laboratory findings
in children with vertigo in a tertiary research hospital.

Methods: A
total of 183 children (65 boys and 118 girls), aged 3-18 (median:14), who presented
with complaints of vertigo between November 2016 and September 2019 in the pediatric
neurology department were examined retrospectively. Systemic and neurological examination
findings, laboratory findings including complete blood count and biochemical tests
(fasting blood glucose, electrolytes, liver-kidney function tests), iron,
iron-binding capacity, ferritin, vitamin B12 level and thyroid function test
results, electroencephalography (EEG) and magnetic resonance imaging findings were
examined.

Results: The
frequency of vertigo complaints were found to be higher in female gender (p = 0.008). The frequency of admission was
significantly higher in adolescents (> 12 years) (67%) compared to other age
groups (p < 0.001). The most common
cause of vertigo was benign paroxysmal vertigo of childhood (BPVC) (23%) and orthostatic
hypotension (22%) was the second. When the relationship between the etiology of
vertigo and age was examined, the most common cause was BPVC under 12 years of
age, where as orthostatic hypotension was significantly more frequent in
adolescents (p < 0.001). Headache
(41%), syncope (27%) and nausea-vomiting (10%) were the most common accompanying
symptoms with vertigo. Epileptiform disorder was detected in 7% of patients who
underwent EEG. Of 171 patients who underwent neuroimaging, 85% reported as
normal and 10% had non-specific findings.

Conclusions: In children presenting with a complaint
of vertigo, a detailed history including the age at when the complaint began and
the accompanying symptoms, physical examination, blood pressure measurement, laboratory
tests, and EEG and neuroimaging (if necessary) should be performed with a
multidisciplinary approach. 

Keywords

vertigo, children, dizziness, differential diagnosis

References

• 1. Erdoğan E, Güzel Nur B, Olgaç Dündar N. [Vertigo in childhood: evaluation of clinical and laboratory findings]. Türkiye Klinikleri J Med Sci 2012;32:1601-6. [Article in Turkish]
• 2. Gioacchini FM, Alicandri-Ciufelli M,Kaleci S, Magliulo G, Re M. Prevalence and diagnosis of vestibular disorders in children: a review. Int J Pediatr Otorhinolaryngol 2014;78:718-24.
• 3. Gruber M, Cohen-Kerem R, Kaminer M, Shupak A. Vertigo in children andaAdolescents: characteristics and outcome. Sci World J 2012;2012:109624.
• 4. Erbek SH, Erbek SS, Yilmaz I, Topal O, Ozgirgin N, Ozluoğlu LN, et al. Vertigo in childhood: a clinical experience. Int J Pediatr Otorhinolaryngol 2006;70:1547-54.
• 5. Jahn K, Langhagen T, Heinen F. Vertigo and dizziness in children. Curr Opin Neurol 2015;28:78-82.
• 6. Devaraja, K. Vertigo in children; a narrative review of the various causes and their management. Int J Pediatr Otorhinolaryngol 2018;111:32-8.
• 7. Raucci U, Vanacore N, Paolino MC, Silenzi R, Mariani R, Urbano A, et al. Vertigo/dizziness in pediatric emergency department: five years' experience. Cephalalgia 2016;36:593-8.
• 8. McCaslin DL, Jacobson GP, Gruenwald JM. The predominant forms of vertigo in children and their associated findings on balance function testing. Otolaryngol Clin North Am 2011;44:291-307.
• 9. Krams B, Echenne B, Leydet J, Rivier F, Roubertie A. Benign paroxysmal vertigo of childhood: long-term outcome. Cephalalgia 2011;31:439-43.
• 10. Wiener-Vacher SR. Vestibular disorders in children. Int J Audiol 2008;47:578-83.
• 11. Ravid S, Bienkowski R, Eviatar L. A simplified diagnostic approach to dizziness in children. Pediatr Neurol 2003;29:317-20.
• 12. Niemensivu R, Kentala E, Wiener-Vacher S, Pyykko I. Evaluation of vertiginous children. Eur Arch Otorhinolaryngol 2007;264:1129-35.
• 13. Furman JM, Marcus DA, Balaban CD. Migrainous vertigo: development of a pathogenetic model and structured diagnostic interview. Curr Opin Neurol 2003;16:5-13.
• 14. Saltürk Z, Yıldırım G, Sünnetçi G, Uyar Y, Atar Y, Kumral TL, et al. Evaluation of vertigo in pediatric age group. Eur Arch Med Res 2014;30:57-62.
• 15. Kluge M, Beyenburg S, Fernandez G, Elger CE. Epileptic vertigo: evidence for vestibular representation in human frontal cortex. Neurology 2000;55:1906-8.
• 16. Riina N, Ilmari P, Kentala E. Vertigo and imbalance in children: a retrospective study in a Helsinki University otorhinolaryngology clinic. Arch Otolaryngol Head Neck Surg 2005;131:996-1000.
• 17. American Academy of Pediatrics. Subcommittee on Management of S, Committee on Quality I. Clinical practice guideline: management of sinusitis. Pediatrics 2001;108:798-808.
• 18. Emiroğlu FN, Kurul S, Akay A, Miral S, Dirik E. Assessment of child neurology outpatients with headache, dizziness, and fainting. J Child Neurol 2004;19:332-6.
• 19. Manrique Lipa RD, Soto Varela A, Santos Pérez S, Manrique Lipa RK, Lorenzo Lorenzo AI, Labella Caballero T. Alterations of balance in patients under 16 years of age distributed by age groups. Acta Otorrinolaringol Esp 2008;59:455-62.
• 20. Bucci MP, Kapoula Z, Yang Q, Wiener-Vacher S, Bremond-Gignac D. Abnormality of vergence latency in children with vertigo. J Neurol 2004;251:204-13.
• 21. Jahn K, Langhagen T, Schroeder AS, Heinen F. Vertigo and dizziness in childhood – update on diagnosis and treatment. Neuropediatrics 2011;42:129-34.
• 22. Dilek E, İşçan B, Ekuklu G, Tütüncüler F. [Retrospective evaluation of the cases diagnosed as Hashimoto’s thyroiditis]. Çocuk Dergisi 2011;11:73-7. [Article in Turkish]
• 23. Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull 2008;29(2 Suppl):S101-11.
• 24. World Health Organization/UNICEF/UNU. Iron deficiency anemia: assessment, prevention, and control. A guide for programme managers. Geneva, Switzerland: World Health Organization; 2001.
• 25. Niemensivu R, Pyykko I, Valanne L, Kentala E. Value of imaging studies in vertiginous children. Int J Pediatr Otorhinolaryngol 2006;70:1639-44.