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[Clinical features of benign paroxysmal positional vertigo in children]
Jing Zhang1, Ying Guo1, Jiao Zhang2
1Otolaryngology of Tianjin Medical University General Hospital,Tianjin,300052,China.
Insights
Benign Paroxysmal Positional Vertigo (BPPV) affects 22.8% of children with vertigo, often presenting with comorbidities and a higher recurrence rate. Early positional testing is crucial for accurate diagnosis in pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Neurology
- Vestibular Disorders
Context:
- Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo in children, yet its diagnostic challenges and clinical characteristics in this population are not fully understood.
- A significant proportion of children presenting with vertigo symptoms are diagnosed with BPPV, highlighting the need for specific diagnostic approaches.
Purpose:
- To investigate the prevalence and clinical characteristics of BPPV in children experiencing vertigo.
- To identify factors associated with BPPV diagnosis, treatment response, and recurrence in pediatric patients.
Summary:
- A retrospective study found BPPV in 22.8% of pediatric vertigo cases, with variations across age groups and an increasing diagnosis trend.
- Key findings include a high rate of comorbidities (49.2%), frequent horizontal semicircular canal involvement, and a 12.3% recurrence rate, notably higher in children with comorbidities.
- Typical positional vertigo history was reported in 72.3% of cases, and canalith repositioning maneuvers showed good treatment outcomes.
Impact:
- This study underscores the importance of considering BPPV in the differential diagnosis of pediatric vertigo and suggests routine positional testing.
- Understanding the clinical profile of childhood BPPV, including its association with comorbidities and recurrence patterns, can guide clinical management and improve diagnostic accuracy.
Abstract:
Objective:To explore relevant factors to accurately diagnose BPPV in vertigo children. Methods:A retrospective study was conducted on the proportion of BPPV in children(<18 years) with vertigo who visited the Hearing and Vertigo Diagnosis and Treatment Center of Tianjin Medical University General Hospital from September 2017 to August 2023. The clinical characteristics of BPPV children, including general demographics, medical history, first visit department, comorbidities, canal involvement, response to treatment, and incidence of recurrence, were analyzed. Data analysis was conducted using SPSS 25.0 software. Results:BPPV was diagnosed in 22.8% of patients seen for vertigo during the study period. There are differences in the proportion of BPPV diagnosis among children with dizziness in different age groups(P<0.05), and the diagnosis of BPPV in the 7-12-year-old group has a longer disease course than in the 13-17-year-old group(P<0.05). 72.3%(47/65) of patients or their families were able to provide a typical history of positional vertigo. 49.2%(32/65) of BPPV patients had comorbidities, and there were differences in the proportion of comorbidities among different age groups of BPPV patients(P<0.05). With the progress of study, the proportion of BPPV in children with vertigo has shown an upward trend, and the proportion of children with otolaryngology as the first diagnosis department has also increased(P<0.05). The proportion of horizontal semicircular canals in children with BPPV has increased. All BPPV patients underwent canalith repositioning maneuvers, with good treatment outcomes and a recurrence rate of 12.3%(8/65). The recurrence rate in the group of BPPV patients with comorbidities was 21.9%, which was higher than that in the group without comorbidities(P<0.05). Conclusion:Childhood BPPV has clinical characteristics such as unclear medical history, high proportion of comorbidities, easy recurrence in BPPV children with comorbidities and high proportion of horizontal semicircular canal involvement. For children diagnosed with other vertigo diseases, do not ignore the BPPV diagnostic test. It is recommended to perform routine position tests on children with vertigo if conditions permit to reduce missed diagnosis of BPPV in children.
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