Vertigo in children and adolescents: characteristics and outcome

Abstract

Objectives: To describe the characteristics and outcome of vertigo in a pediatric population.

Patients: All children and adolescents presenting with vertigo to a tertiary otoneurology clinic between the years 2003-2010 were included in the study.

Results: Thirty-seven patients with a mean age of 14 years were evaluated. The most common etiology was migraine-associated vertigo (MAV) followed by acute labyrinthitis/neuritis and psychogenic dizziness. Ten patients (27%) had pathological findings on the otoneurological examination. Abnormal findings were documented in sixteen of the twenty-three (70%) completed electronystagmography evaluations. Twenty patients (54%) were referred to treatment by other disciplines than otology/otoneurology. A follow-up questionnaire was filled by twenty six (70%) of the study participants. While all patients diagnosed with MAV had continuous symptoms, most other patients had complete resolution.

Conclusions: Various etiologies of vertigo may present with similar symptoms and signs in the pediatric patient. Yet, variable clinical courses should be anticipated, depending on the specific etiology. This is the reason why treatment and follow up should be specifically tailored for each case according to the diagnosis. Close collaboration with other medical disciplines is often required to reach the correct diagnosis and treatment while avoiding unnecessary laboratory examinations.

Figure 1

Distribution of the various etiologies for vertigo. MAV: migraine-associated vertigo, VN: vestibular neuritis, BPVC: benign paroxysmal vertigo of childhood, and SMD: space and motion discomfort.