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Vertigo in childhood: a retrospective series of 100 children
Ezgi Deniz Batu1, Banu Anlar2, Meral Topçu2
1Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey.
Insights
Pediatric vertigo evaluation varies, but a new algorithm aids diagnosis. Benign paroxysmal vertigo of childhood is common in younger children, while psychogenic vertigo is more frequent in older children.
Area of Science:
- Pediatric Neurology
- Vestibular Disorders
- Clinical Diagnostics
Background:
- Vertigo evaluation and management in children lack standardization across institutions and specialties.
- Understanding the diverse causes and characteristics of pediatric vertigo is crucial for accurate diagnosis.
Purpose of the Study:
- To characterize vertigo presentations in children at a pediatric neurology referral center.
- To explore the association between vertigo and migraine in pediatric patients.
- To develop and validate a diagnostic algorithm for pediatric vertigo.
Main Methods:
- Retrospective analysis of 100 pediatric patients (<18 years) presenting with vertigo between 1996-2012.
- Data collection via patient files and phone interviews.
- Development of a diagnostic algorithm based on study findings and literature review.
Main Results:
- The most common causes were benign paroxysmal vertigo of childhood (BPVC) (39%), psychogenic vertigo (21%), epileptic vertigo (15%), and migraine-associated vertigo (MAV) (11%).
- BPVC was prevalent in children ≤5 years, while psychogenic vertigo was more common in those >5 years.
- A diagnostic algorithm correctly classified 88% of cases.
Conclusions:
- Most childhood vertigo cases can be diagnosed through thorough history and examination.
- A standardized diagnostic algorithm can significantly improve the accurate classification of pediatric vertigo.
Objective:
Evaluation and management of vertigo in children vary between institutions and medical specialties. The aim of this study is to describe the characteristics of vertigo in children presenting to a pediatric neurology referral center and to investigate the relationship between vertigo and migraine.
Study Design:
Patients <18 years old presenting with vertigo to Hacettepe University Ihsan Dogramaci Children's Hospital Neurology Unit between January 1996-January 2012 were included (n = 100). Data were obtained from patient files and phone interviews.
Results:
Mean age was 7.5 years. The most common etiological groups were benign paroxysmal vertigo of childhood (BPVC) (39%), psychogenic vertigo (21%), epileptic vertigo (15%), and migraine-associated vertigo (MAV) (11%). BPVC was the most common diagnosis in children ≤5 years of age while psychogenic vertigo prevailed in children >5 years. Staring episodes characterized epileptic vertigo patients (p = 0.021) while headache was more often described by MAV patients (p < 0.001). Vertigo attacks >5 min were uncommon in BPVC patients compared to others (p = 0.013). Twenty percent of BPVC patients contacted through phone interviews were experiencing migraine type headaches that started at a median age of 7.5 years. An algorithm for evaluation of children with vertigo was formed based on data obtained from this study and the literature. When this algorithm was applied to 100 cases of this series, 88 (88%) were correctly diagnosed.
Conclusion:
While most vertigo cases in children can be diagnosed accurately by a detailed medical history, physical and neurological examination, a standard algorithm can help with the correct classification.
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