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[Vertigo in children. Clinical presentation, course and treatment]
1Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Marchioninistrasse 15, 81377 München. klaus.jahn@med.uni-muenchen.de
Insights
Diagnosing vertigo in children is challenging but crucial for effective treatment and parental reassurance. Migraine-associated vertigo and vestibular failure are common, requiring prompt recognition by primary care physicians.
Area of Science:
- Pediatric Neurology
- Otolaryngology
- Vestibular Disorders
Context:
- Vertigo diagnosis in children presents unique challenges.
- Accurate diagnosis is essential for targeted therapy and reducing parental anxiety.
- Understanding common and rare causes of pediatric vertigo is critical.
Purpose:
- To outline the diagnostic challenges and common etiologies of vertigo syndromes in pediatric populations.
- To emphasize the importance of recognizing migraine-associated vertigo and vestibular failure in children.
- To guide primary care physicians in the diagnostic workup of pediatric vertigo.
Summary:
- Migraine-associated vertigo (including benign paroxysmal vertigo of childhood and vestibular migraine) accounts for approximately 50% of pediatric vertigo diagnoses.
- Acute unilateral vestibular failure due to labyrinthitis is more prevalent in children than adults.
- Rare congenital syndromes causing bilateral vestibular failure and central causes like brainstem/cerebellar tumors (requiring MRI) must also be considered.
Impact:
- Facilitates timely and accurate diagnosis of pediatric vertigo, leading to appropriate management.
- Reduces unnecessary investigations and alleviates parental concerns regarding childhood vertigo.
- Enhances the diagnostic capabilities of primary care physicians in managing pediatric vestibular disorders.
Abstract:
The diagnosis of vertigo syndromes in childhood is considered a difficult challenge. A correct diagnosis, however, makes successful therapy possible, prevents unnecessary investigations and alleviates the worries of parents. Migraine-associated forms of vertigo are very common in children (benign paroxysmal vertigo of childhood, vestibular migraine) and account for about 50% of diagnoses. Acute unilateral vestibular failure in the course of infectious and para-infectious labyrinthitis is also more common in children than in adults. Motion sickness is a frequent and relevant problem in children aged 4-10 years old. A number of rare congenital syndromes can occur with bilateral vestibular failure. Because of the relatively high frequency of brainstem and cerebellar tumors in children, MRI should be considered in all patients presenting with subacute central vestibular signs. In principle, all forms of vertigo known in adult patients can also occur in children; however, they must gradually be included in the diagnostic spectrum of the primary care physician (e.g., vestibular paroxysm).
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