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Quantitative Vestibular Function Testing in the Pediatric Population
Kristen L Janky1, Amanda I Rodriguez1
1Department of Audiology, Boys Town National Research Hospital, Omaha, Nebraska.
Insights
This guide details vestibular function tests for children, including the head impulse test (HIT) and vestibular evoked myogenic potential (VEMP). Age-specific recommendations ensure accurate diagnosis of vestibular loss in pediatric patients.
Area of Science:
- Pediatric Neurology
- Otolaryngology
- Neuroscience
Background:
- Vestibular dysfunction can significantly impact a child's development and quality of life.
- Accurate diagnosis of vestibular loss in children is crucial for timely intervention.
- Standard vestibular function tests require age-appropriate adaptations for pediatric assessment.
Purpose of the Study:
- To provide an overview of quantitative vestibular function tests in children.
- To outline age-specific recommendations for performing these tests.
- To discuss modifications and considerations for pediatric vestibular testing.
Main Methods:
- Review of quantitative vestibular tests: caloric, VEMP (cervical and ocular), rotary chair, and head impulse test (HIT/vHIT).
- Age-stratified recommendations for test selection (0-2, 3-7, 8+ years).
- Inclusion of screening measures and symptom questionnaires for dizziness and vestibular loss.
Main Results:
- Specific vestibular tests are recommended based on a child's age group.
- For infants (0-2 years): rotary chair, cervical VEMP, and vHIT.
- For older children (3-7 and 8+ years): vHIT, Ocular VEMP, Cervical VEMP, and caloric testing (if indicated).
Conclusions:
- Age-appropriate vestibular function testing is essential for diagnosing pediatric vestibular loss.
- Modifications to standard tests can be implemented to accommodate children.
- Comprehensive vestibular assessment aids in managing dizziness and improving functional outcomes.
Abstract:
Quantitative tests of vestibular function include the caloric test, cervical and ocular vestibular evoked myogenic potential (VEMP), rotary chair, and head impulse test, either at the bedside or utilizing video head impulse test (vHIT). The purpose of this article is to provide an overview of how to perform these tests in children, including which tests are recommended based on the child's age and any modifications or considerations that can be made. A variety of clinical measures have been recommended as screening measures for vestibular loss, which will be reviewed. Symptom questionnaires designed to assess the functional impact of dizziness and vestibular loss in children will also be discussed. If a child complains of dizziness or if vestibular loss is suspected (either by case history or positive screening measure), vestibular function testing is warranted. For vestibular function testing, children aged 0 to 2 years typically receive rotary chair, cervical VEMP, and vHIT if a remote system is available. For children aged 3 to 7 years, vHIT, cervical VEMP, and ocular VEMP are completed, and for children aged 8+ years, vHIT, caloric testing if vHIT is normal, and cervical and ocular VEMP are completed. For all children, modifications to testing can be made, as needed.
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