Otoneurologic evaluation of child vertigo

Area of Science:

• Pediatric Otolaryngology
• Neurology
• Vestibular Disorders

Background:

• Vertigo in children is complex, with diverse etiologies.
• Previous classifications group vertigo with cochlear diseases, as an isolated symptom, or with central nervous system (CNS) diseases.
• The etiopathogenesis of isolated vertigo in children remains poorly understood.

Purpose of the Study:

• To investigate the characteristics and etiopathogenesis of vertigo in 282 children.
• To focus on children with isolated vertigo due to diagnostic challenges.
• To identify the incidence and nature of paroxysmal benign vertigo (PBV) in this pediatric population.

Main Methods:

• Classification of 282 children into three groups: vertigo with cochlear diseases, isolated vertigo, and vertigo with CNS diseases.
• Detailed anamnestic, clinical, and instrumental analysis.
• Focus on the isolated vertigo group for in-depth investigation.

Main Results:

• The frequency order of groups was: vertigo with CNS diseases > vertigo with cochlear diseases > isolated vertigo.
• Isolated vertigo, though less frequent overall, includes paroxysmal benign vertigo (PBV), the second most common vertiginous form.
• Iatrogenic syndromes were noted with significant incidence in the isolated vertigo group.

Conclusions:

• A definitive etiopathogenetic cause for apparently isolated vertigo (excluding iatrogenic forms) is often not identifiable.
• Paroxysmal benign vertigo (PBV) is frequently encountered but poorly understood, diagnosed primarily by exclusion.
• Emphasis is placed on the prevention of iatrogenic syndromes in pediatric vertigo management.