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Effectiveness and acceptance of Vestibulo-Ocular Reflex adaptation training in children with recurrent vertigo with

Ning Ma1,2, Handi Liu1,2, Bing Liu1,2

  • 1Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Frontiers in Neurology
|January 2, 2023
PubMed

Insights

Vestibular rehabilitation training, specifically Vestibulo-Ocular Reflex (VOR) adaptation, effectively improves vertigo symptoms in children with unilateral vestibular dysfunction (UVD) and normal balance. This VOR adaptation training showed better acceptance and outcomes compared to Cawthorne-Cooksey exercises.

Area of Science:

  • Pediatric Neurology
  • Vestibular Rehabilitation
  • Ophthalmology

Background:

  • Recurrent vertigo in children with unilateral vestibular dysfunction (UVD) and normal balance presents a therapeutic challenge.
  • Vestibular rehabilitation aims to improve balance and reduce vertigo symptoms through targeted exercises.

Purpose of the Study:

  • To evaluate the effectiveness and acceptance of Vestibulo-Ocular Reflex (VOR) adaptation training compared to Cawthorne-Cooksey training and a control group in children with recurrent vertigo.
  • To assess the impact of VOR adaptation on vertigo symptoms, quality of life, and vestibular function.

Main Methods:

  • A block randomized controlled study involving 30 children (aged 4-13) with recurrent vertigo, UVD, and normal balance.
  • Participants were assigned to VOR adaptation training, Cawthorne-Cooksey training, or a control group for 1 month, with all receiving Ginkgo biloba.
  • Outcomes measured included Dizziness Handicap Inventory (DHI), Visual Analog Scale of Quality of Life with Vertigo (VAS-QLV), and canal paralysis (CP) on caloric testing.

Main Results:

  • The VOR adaptation group (Group A) showed a 100% effective rate and 100% recovery on caloric testing, significantly outperforming the Cawthorne-Cooksey (Group B) and control (Group C) groups.
  • Significant improvements in DHI and VAS-QLV scores were observed in Group A compared to other groups (P < 0.05).
  • Acceptance (VAS-A score) was significantly higher for VOR adaptation training (7.6 ± 2.2) compared to Cawthorne-Cooksey training (3.1 ± 2.8) (P = 0.004).

Conclusions:

  • Vestibular rehabilitation training is recommended for children experiencing vertigo.
  • VOR adaptation training offers an effective, time-efficient, and well-accepted treatment for children with recurrent vertigo, UVD, and normal balance.
  • The simplicity and superior outcomes of VOR adaptation make it a preferred choice over traditional Cawthorne-Cooksey exercises.
Abstract

Keywords:
Vestibulo-Ocular Reflexchildrenrecurrent vertigo of childhoodunilateral vestibular dysfunctionvestibular rehabilitation

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