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Prevalence of Vestibular Dysfunction in Children With Neurological Disabilities: A Systematic Review
Shashank Ghai1,2, Mireille Hakim1,3, Elizabeth Dannenbaum2
1School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
Insights
Vestibular dysfunction is common in children with cerebral palsy, traumatic brain injury, sensorineural hearing loss, or cochlear implants. Early diagnosis of these vestibular disorders is crucial for improving functional outcomes.
Area of Science:
- Pediatric Neurology
- Audiology
- Vestibular System Disorders
Background:
- Vestibular disorders frequently co-occur with neurological and neurodevelopmental conditions in children.
- These co-existing conditions can exacerbate disability and limit functional independence.
- Increased awareness can lead to earlier diagnosis and improved treatment for pediatric vestibular dysfunction.
Approach:
- Systematic literature review of studies published until June 2018.
- Analysis of data from EMBASE, MEDLINE, and CINAHL databases.
- Inclusion of 24 studies examining children and adolescents aged 3-21 years.
Key Points:
- Prevalence of saccular dysfunction in spastic cerebral palsy (CP) was 48.4% in one study.
- Post-traumatic brain injury (TBI), vestibular dysfunction prevalence ranged from 14.6% to 81%.
- Prevalence in sensorineural hearing loss (SNHL) varied from 18.7% to 96.1%, and in cochlear implant (CI) recipients from 3% to 84%.
Conclusions:
- Vestibular dysfunction is highly prevalent across diverse pediatric populations including CP, TBI, SNHL, and CI.
- Clinicians must recognize the high incidence of vestibular issues in these children.
- Implementing targeted vestibular assessments is essential for optimizing patient care and outcomes.
Abstract:
Background: In children with neurological or neurodevelopmental conditions, vestibular disorders may co-exist with the primary condition and further contribute to disability and restriction in functional independence and participation. Awareness of their existence may favor an early diagnosis and better treatment outcomes. Objectives: To determine the prevalence of vestibular dysfunction in children and adolescents (3-21 years old) diagnosed with either cerebral palsy (CP), traumatic brain injury (TBI), sensorineural hearing loss (SNHL), or cochlear implantations (CI). Methods: Four researchers systematically reviewed the literature from three databases (EMBASE, MEDLINE, CINAHL) until June 2018. Results: Twenty-four studies were analyzed in this systematic review. A single, high-quality study reports a prevalence of 48.4% of spastic CP children having a saccular dysfunction. Three fair-quality studies report a prevalence of 14.6-81%, 21 days post-TBI. Twelve poor-to-high quality studies demonstrate a prevalence of 18.7-96.1% in children with SNHL. A prevalence range of 3-84% in children with CI is reported by nine fair-to-high quality studies. Conclusion: Clinicians should be aware of the prevalence of vestibular dysfunction in these populations and implement appropriate assessments to improve treatment outcomes.
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