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The First 100 Children Treated in a Newly Established Pediatric Vertigo Center
Mohammed K Alnoury1, Samer Salameh2, Aleksandra Ostrovska3
1Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Insights
Diagnosing pediatric vertigo is challenging. Vestibular testing is more effective than imaging or audiology for identifying causes like vestibular migraine in children.
Area of Science:
- Pediatric Otolaryngology
- Neurology
- Vestibular Disorders
Background:
- Pediatric dizziness diagnosis is complex due to communication and examination challenges.
- A new pediatric vertigo center was established to address these diagnostic difficulties.
Purpose of the Study:
- To describe the initial patient cohort at a specialized pediatric vertigo center.
- To analyze diagnostic trends, investigations, and treatments for pediatric vertigo.
Main Methods:
- Retrospective review of 100 consecutive pediatric patients.
- Data collected included clinical information, diagnoses, and treatments.
- Diagnoses were confirmed by pediatric otolaryngologists using validated criteria.
Main Results:
- Vestibular migraine (20%) and benign paroxysmal vertigo of childhood (14%) were most common.
- Vestibular testing revealed abnormalities in 62.5% of tested children.
- Imaging and audiology showed low diagnostic yield.
Conclusions:
- Vestibular testing is valuable for diagnosing pediatric vertigo, especially vestibular migraine.
- Imaging and audiology have limited utility in pediatric vertigo assessment.
- Multidisciplinary centers are crucial for accurate pediatric vertigo diagnosis and management.
Background:
Correctly diagnosing dizziness in children is essential for appropriate management; nevertheless, healthcare professionals face challenges due to children's limited ability to describe their symptoms and their cooperation during physical examination. The objective of this study is to describe the first 100 patients seen at a newly established pediatric vertigo center.
Methods:
This is a retrospective review of a consecutive series of 100 patients seen at our pediatric vertigo clinic in a tertiary referral center from August 2019 until June 2022. Comprehensive clinical data were collected. The diagnoses were established by 2 pediatric otolaryngologists based on validated diagnostic criteria. Trends in diagnosis, investigation, and treatment of these patients were analyzed.
Results:
A total of 100 children were included in the study. Vestibular migraine was the most common diagnosis (20%) followed by benign paroxysmal vertigo of childhood (14%). Eleven patients had combined pathologies. Fifteen out of 70 children (21%) had abnormal audiograms, 30 out of 48 children (62.5%) had abnormal vestibular testing, and 6 out of 31 (19%) patients had abnormal imaging. Fifty-one children received medical treatment, 23 received vestibular physiotherapy, and 9 patients had particle repositioning maneuvers; moreover, 17 of these patients received multimodal treatment.
Conclusions:
Our analysis suggests that imaging and audiology testing have relatively low yield in the assessment of pediatric vertigo. On the other hand, vestibular testing detected a high proportion of abnormalities, such as saccadic pursuit, vertical nystagmus, central positional nystagmus, and abnormal directional preponderance, particularly associated with vestibular migraine. Given the complexity of diagnosing vertigo in children, it is critical to establish multidisciplinary specialized centers capable of providing accurate diagnosis and treatment for these children.
