Related Experiment Video
Updated: Sep 23, 2025
Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction
Published on: August 30, 2019
Vestibular and balance dysfunction in children with congenital CMV: a systematic review
Annalie Shears1,2, Georgina Yan3,4, Harriet Mortimer5
1Department of Paediatrics, Royal Manchester Children's Hospital, Manchester, UK.
Insights
Vestibular dysfunction is common in children with congenital cytomegalovirus (cCMV), affecting both symptomatic and asymptomatic cases. Early audiovestibular assessments are crucial for neurodevelopmental follow-up in these children.
Area of Science:
- Pediatric Neurology
- Audiology
- Developmental Pediatrics
Background:
- Congenital cytomegalovirus (cCMV) is a leading infectious cause of non-genetic sensorineural hearing loss.
- Vestibular and balance dysfunction are potential sequelae of cCMV, impacting neurodevelopment.
- Systematic evaluation of these deficits in cCMV is essential for clinical management.
Purpose of the Study:
- To systematically review vestibular and balance dysfunction in children with cCMV.
- To provide recommendations for clinical practice.
- To identify future research priorities in this area.
Main Methods:
- A comprehensive search of multiple databases (MEDLINE, Embase, etc.) was conducted up to March 2021.
- 16 observational studies, involving 600 children with cCMV, were included and assessed using STROBE criteria.
- Studies focused on vestibular function and balance assessments in children diagnosed with cCMV within the first three weeks of life.
Main Results:
- Vestibular dysfunction was reported in at least 40% of children with cCMV across 10 of 12 studies that performed vestibular testing.
- Symptomatic cCMV cases showed higher rates of vestibular dysfunction (22%-60%) compared to asymptomatic cases (0%-12.5%).
- Two studies indicated a deterioration of vestibular function over time in affected children.
Conclusions:
- Vestibular dysfunction is prevalent in children with cCMV, irrespective of symptomatic status or hearing loss.
- Audiovestibular assessments should be integrated into the neurodevelopmental follow-up of all children with cCMV.
- Further case-controlled longitudinal studies are needed to characterize vestibular dysfunction and evaluate interventions.
Objective:
This systematic review evaluates vestibular and balance dysfunction in children with congenital cytomegalovirus (cCMV), makes recommendations for clinical practice and informs future research priorities.
Design:
MEDLINE, Embase, EMCARE, BMJ Best Practice, Cochrane Library, DynaMed Plus and UpToDate were searched from inception to 20 March 2021 and graded according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.
Patients:
Children with cCMV diagnosed within 3 weeks of life from either blood, saliva and/or urine (using either PCR or culture).
Intervention:
Studies of vestibular function and/or balance assessments.
Main Outcome Measures:
Vestibular function and balance.
Results:
1371 studies were identified, and subsequently 16 observational studies were eligible for analysis, leading to an overall cohort of 600 children with cCMV. All studies were of low/moderate quality. In 12/16 studies, vestibular function tests were performed. 10/12 reported vestibular dysfunction in ≥40% of children with cCMV. Three studies compared outcomes for children with symptomatic or asymptomatic cCMV at birth; vestibular dysfunction was more frequently reported in children with symptomatic (22%-60%), than asymptomatic cCMV (0%-12.5%). Two studies found that vestibular function deteriorated over time: one in children (mean age 7.2 months) over 10 months and the other (mean age 34.7 months) over 26 months.
Conclusions:
Vestibular dysfunction is found in children with symptomatic and asymptomatic cCMV and in those with and without hearing loss. Audiovestibular assessments should be performed as part of neurodevelopmental follow-up in children with cCMV. Case-controlled longitudinal studies are required to more precisely characterise vestibular dysfunction and help determine the efficacy of early supportive interventions.
Prospero Registration:
CRD42019131656.
Related Concept Videos
01:29The Vestibular System
01:15Equilibrium and Balance