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Evaluation and diagnosis of pediatric patients with dizziness
Karl W Doerfer1, Erin Harvey, Samantha LaPrade
1Medical College of Wisconsin, Department of Otolaryngology & Communication Sciences, 9200 W. Wisconsin Ave., Milwaukee, Wisconsin, USA.
Insights
Pediatric dizziness often involves non-vestibular causes like migraine or concussion. Otolaryngologists can aid diagnosis by understanding these common pediatric dizziness conditions.
Area of Science:
- Otolaryngology
- Pediatric Neurology
- Vestibular Science
Background:
- Pediatric dizziness is often undiagnosed due to systemic barriers.
- Otolaryngologists are frequently consulted despite most causes not involving the peripheral vestibular system.
Purpose of the Study:
- Provide otolaryngologists with an overview of pediatric dizziness and imbalance.
- Facilitate evaluation and management of children with dizziness.
Main Methods:
- Literature review of pediatric dizziness etiologies.
- Focus on conditions relevant to otolaryngologic consultation.
Main Results:
- Serious central nervous system conditions must be ruled out first.
- Migraine-related conditions, concussion, and functional disorders account for ~70% of non-hazardous cases.
- Peripheral vestibular dysfunction can include inner ear malformations and adult-like vestibular disorders.
Conclusions:
- Otolaryngologists need familiarity with pediatric dizziness causes.
- Understanding diverse etiologies aids diagnosis and management, even if outside their primary scope.
Purpose Of Review:
Children experiencing dizziness frequently go unevaluated or experience delays in correct diagnosis due to systemic and inherent barriers. While most causes of pediatric dizziness do not involve the peripheral vestibular system, otolaryngologists are frequently consulted for expert opinion. This study offers a broad overview of the leading causes of pediatric dizziness and imbalance to assist otolaryngologists with evaluating and managing this challenging population.
Recent Findings:
Evaluation of children with dizziness should exclude serious central nervous system conditions. Approximately 70% of nonhazardous cases of pediatric dizziness are caused by migraine-related conditions, concussion, or functional disorders. Etiologies for peripheral vestibular dysfunction include inner ear malformations and vestibular disorders more commonly seen in adults. Audiometric and vestibular testing can provide helpful information, although correct diagnosis depends on a detailed history.
Summary:
Otolaryngologists should be familiar with the conditions that cause dizziness in children. While most underlying causes are outside their scope of practice, understanding possible etiologies can facilitate correct diagnosis and appropriate management.
