Çocuklarda Vertigo; Ayırıcı Tanı

Abstract

Çocuklarda baş dönmesi nadir görülen bir şikayet olmasına rağmen gerek hastada gerekse ailede ortaya çıkardığı anksiyete nedeniyle önemli bir sorundur. Çocuklarda ifade zorluğuna bağlı tanı ve tedavide ciddi sorunlar yaşanmaktadır. Baş dönmesi şikayeti ile gelen çocuk hastada ayrıntılı bir anamnez ve fizik muayene hâlâ tanı koymada en etkili yöntemler olarak durmaktadır. Baş dönmesi şikayetinin en sık nedenleri arasında benign paroksismal vertigo, migren ve kafa travması izlenmektedir. Diğer nedenler ise; vestibüler nörinit, meniere hastalığı, benign pozisyonel paroksismal vertigo, psikojenik, otitis media, santral sinir sistem patolojileri ve ortostatik hipotansiyondur. Baş dönmesi sorunu yaşayan çocuklardaki en önemli problemlerden bir tanesi de kognitif ve motor gelişimin etkilenmesidir ve bu çocuklar mutlaka pediatrist, nörolog, oftalmolog ve gerek halinde ortopedist ve fizyoterapist ile birlikte değerlendirilmelidir.

Keywords

• Çocuk, Dengesizlik, Vertigo

Vertigo in Children; Differential Diagnosis

Abstract

Although vertigo is a rare complaint in children, it is an important problem for both the patient and the family because of the anxiety that it creates. Difficulty of expression in children leads to serious problems in the diagnosis and treatment of vertigo. A detailed anamnesis and physical examination is still the most effective method of diagnosis in children with vertigo. Benign paroxysmal vertigo, migraine and head trauma are the most common causes of a vertigo complaint. Other common reasons are vestibular neuronitis, meningitis, benign positional paroxysmal vertigo, psychogenic, otitis media, central nervous system pathologies and orthostatic hypotension. One of the most important problems in children with vertigo is the effect on cognitive and motor development, and these children should be evaluated together with the pediatrician, neurologist, ophthalmologist and, if necessary, orthopedist and physiotherapist

Keywords

• Child, Dizziness, Vertigo

References

1. O’Reilly RC, Morlet T, Nicholas BD, Josephson G, Horlbeck D, Lundy L, et al. Prevalence of vestibular and balance disorders in children. Otol Neurotol 2010;31:1441-4.
2. Strupp M, Zingler VC, Arbusow V, Niklas D, Maag KP, Dieterich M, et al. Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 2004;351:354–61.
3. Hausler R, Toupet M, Guidetti G, Basseres F, Montandon P. Menière’s disease in children. Am J Otolaryngol 1987;8:187-93.
4. Fujii K, Ito Y, Mizuta K, Shirato H, Sawai S, Sakuma S. Vertigo and equilibrium disturbance in children: A clinical study. Equilib Rs 1994;53:374-80.
5. Golding JF, Gresty MA. Pathophysiology and treatment of motion sickness. Curr Opin Neurol 2015;28:83-8.
6. Bronstein AM, Golding JF, Gresty MA. Vertigo and dizziness from environmental motion: MS and Drivers’ disorientation. Semin Neurol 2013;33:219–30.
7. Ressiot E, Dolz M, Bonne L, Marianowski R. Prospective study on the efficacy of optokinetic training in the treatment of seasickness. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 130:263–8.
8. Lucertini M, Verde P, Trivelloni P. Rehabilitation from airsickness in military pilots: Long-term treatment effectiveness. Aviat Space Environ Med 2013; 84:1196–200.

9. 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.
10. Kim KS, Kim YH, Hwang Y, Kang B, Kim DH, Kwon YS. Epileptic nystagmus and vertigo associated with bilateral temporal and frontal lobe epilepsy. Clin Exp Otorhinolaryngol 2013;6:259-62.
11. Raucci U, Scateni S, Tozzi AE, Drago F, Giordano U, Marcias M, et al. The availability and the adherence to pediatric guidelines for the management of syncope in the emergency department. J Pediatr 2014; 165: 967–72.
12. term follow-up. Int J Pediatr Otorhinolaryngol 2000;54:117-21.