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Persistent Postural-Perceptual Dizziness in Children and Adolescents
Alicia Wang1, Katie M Fleischman1,2, Kosuke Kawai1,2
1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital.
Summary
Persistent postural-perceptual dizziness (PPPD) affects children and adolescents, often impacting school attendance. Treatments including physical therapy, CBT, and SSRI medication show promise for symptom resolution in pediatric patients.
Area of Science:
- Neurology
- Otolaryngology
- Pediatrics
Background:
- Persistent postural-perceptual dizziness (PPPD) is a chronic condition characterized by dizziness and unsteadiness.
- While studied in adults, pediatric cases of PPPD are less understood.
- This study focuses on the presentation and treatment of PPPD in young individuals.
Purpose of the Study:
- To describe the clinical presentation of PPPD in a pediatric cohort.
- To evaluate the effectiveness of various treatments for pediatric PPPD.
- To highlight the impact of PPPD on young patients' daily lives.
Main Methods:
- Retrospective chart review of patients aged 21 years or younger.
- Inclusion criteria: diagnosis of PPPD based on Bárány Society criteria and follow-up of at least 6 months.
- Data collected included demographics, comorbidities, symptom duration, and treatment response.
Main Results:
- 53 pediatric patients were identified, with 83% being female and a mean age of 14.6 years.
- Common co-diagnoses included benign paroxysmal positional vertigo and vestibular migraine.
- Symptom resolution occurred in 34% of patients, with physical therapy, CBT, and SSRI medication showing potential benefits, especially in combination.
Conclusions:
- PPPD significantly impacts children and adolescents, leading to missed school days.
- Effective treatment strategies may involve a multimodal approach including physical therapy, cognitive behavioral therapy, and SSRI medication.
- Further research is needed to fully understand and manage PPPD in pediatric populations.
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