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Published on: August 22, 2025

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The Impact of Follow-Up on Etiological Classification of Pediatric Vertigo

Nina Božanić Urbančič1,2, Dejan Mladenov1, Saba Battelino1,2

  • 1Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.

Children (Basel, Switzerland)
|March 28, 2026
PubMed

Insights

Extended follow-up significantly improves the diagnosis of vertigo and dizziness in children. This approach reduces diagnostic uncertainty and optimizes the use of investigations for pediatric vertigo.

Area of Science:

  • Pediatric Otolaryngology
  • Neurology
  • Vestibular Disorders

Background:

  • Vertigo and dizziness in children present diagnostic challenges with diverse causes.
  • Many pediatric patients lack a definitive diagnosis upon initial evaluation.
  • Limited evidence exists on the impact of long-term follow-up for classifying pediatric vertigo etiologies.

Purpose of the Study:

  • To reassess the etiological classification of pediatric vertigo and dizziness using extended follow-up data.
  • To evaluate the impact of longitudinal follow-up on diagnostic accuracy in pediatric vertigo.
  • To compare etiological distributions before and after extended follow-up.

Main Methods:

  • Observational cohort study with prospectively collected data from children aged 1-17 years.
  • Retrospective revision of a previously published cohort, incorporating extended follow-up data up to 2025.
  • Descriptive statistics to compare etiological classifications at initial presentation versus after extended follow-up.

Main Results:

  • The proportion of unclassified etiologies decreased from 44% to 10% after extended follow-up.
  • Identified etiologies included central (35%), peripheral vestibular (18%), hemodynamic (16%), and psychogenic (10%).
  • Extended follow-up averaged 17.6 months, revealing low diagnostic yield for certain tests like cranial CT.

Conclusions:

  • Extended follow-up substantially enhances etiological classification in pediatric vertigo and dizziness.
  • Initial diagnostic uncertainty often stems from evolving clinical presentations, not a lack of underlying pathology.
  • A longitudinal, multidisciplinary approach is crucial for accurate diagnosis and optimized investigation use in pediatric vertigo.

Keywords:
dizzinessetiologyfollow-upmigrainepediatric vertigovestibular disorders

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