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Published on: September 1, 2023
[Alterations of balance in patients under 16 years of age distributed by age groups]
Rubén Duilio Manrique Lipa1, Andrés Soto Varela, Sofía Santos Pérez
1Departamento de Otorrinolaringología, Complejo Hospitalario Universitario de Vigo, Hospital do Meixoeiro, Pontevedra, España. rben03811@hotmail.com
Insights
Childhood benign paroxysmal vertigo is common in children with balance issues. Clinical history and neuro-otological exams are key for diagnosing infantile vestibular pathology, not imaging.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Vestibular System Disorders
Context:
- Altered balance in children is a significant clinical concern.
- Vestibular pathology in pediatric populations requires accurate diagnostic approaches.
- Understanding the prevalence and characteristics of infantile balance disorders is crucial.
Purpose:
- To determine the prevalence and clinical features of balance alterations in children.
- To assess the diagnostic utility of audiological, balance, and imaging studies for infantile vestibular pathology.
- To establish the importance of clinical history and neuro-otological examination in diagnosis.
Summary:
- Childhood benign paroxysmal vertigo was the most frequent diagnosis (64%) in 125 pediatric patients with balance issues.
- Infantile positional vertigo and psychogenic vertigo were more common in older children (11-15 years).
- Clinical history and neuro-otological examination are paramount for diagnosing infantile vestibular pathology; imaging is useful only in specific neurological cases.
Impact:
- Highlights the primary role of clinical assessment in diagnosing pediatric vestibular disorders.
- Suggests that audiological and balance studies, along with imaging, have limited diagnostic value for common infantile vestibular pathologies.
- Emphasizes the need for age-standardized diagnostic approaches in pediatric balance assessment.
Objective:
To evaluate the prevalence and clinical characteristics of children with altered balance, as well as to establish the level of importance of the audiological, balance and imaging studies in the diagnosis of infantile vestibular pathology.
Patients And Method:
We report a descriptive, retrospective and non-randomized study performed at the Otorhinolaryngology Department of the Complejo Hospitalario Universitario de Santiago de Compostela (Santiago de Compostela University Hospital, Santiago de Compostela, Spain). The study included 125 patients under 16 years of age who consulted due to alterations in their balance over a period of twelve years (1996 to 2007); they are distributed into three groups based on age: 0 to 5, 6 to 10, and 11 to 15 years.
Results:
Childhood benign paroxysmal vertigo (64 %) is the most frequent syndrome in our series, with 32.5 % of patients associating common migraine. Together with diagnoses of infantile positional vertigo and psychogenic vertigo, was more frequently found in the 11 to 15 year-old age group (P< .05). Age, gender and the results of the imaging studies (computerized tomography of the brain and magnetic resonance of the head) were not related to the presentation of associated migraine nor to the diagnosis (P>.05).
Conclusions:
Clinical history and the neuro-otological examination are the key elements of the diagnosis of infantile vestibular pathology; it is also important to standardize and group patients by age. Imaging studies only contribute high diagnostic performance in children presenting neurological symptoms, persistent headache or who have sustained head trauma.
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