Vertigo in children is uncommon.The attacks of vertigo in children may be less dramatic than adults,however they cause severe anxiety if a diagnosis is not reached and appropriately explained.
The clinical diagnosis involves accurate history which many adults are not capable of giving.The reason I say so is that the terms “Vertigo” “Dizziness””Giddiness” and “Imbalance” are very commonly used without proper understanding by adult patients,let alone poor child!
When a child presents with vertigo, we also need to keep in mind their distractibility,coordination capabilities and behavioral problems.Also the compliance in pediatric population to perform otoneurological examinations is limited
Let us go through various terms commonly used by patients or parents.
Dizziness can be used to explain different sensations like lightheadedness, Fainting or Syncope, Giddiness (when engaging in activities like spinning) or Vertigo.
Vertigo is a sensation of spinning (either we feel spinning or the surrounding is spinning).It can be associated with nausea,jerky eye movements,headache,sweating and ringing in the ears or hearing loss.
Vertigo is an uncommon complaint in children and adolescents.Despite the most significant technological achievements in the development of diagnostic tools like scans and audiology, diagnosis is still based mainly upon the patient’s history and physical examination.There could be history of migraine or vertigo in the family.
The child’s pediatrician may refer to Pediatric ENT for further otologic and audiologic evaluation.If required, the child may be seen by neurologist for evaluation.
There have been various scientific studies about the etiologies or causes of vertigo in children.The common causes of vertigo or the differential diagnosis includes Migraine associated vertigo or variants,Benign Paroxysmal Vertigo, Otitis Media and rarely other inner ear pathologies.
It is worth mentioning about “Motion Sickness” here.
It is a clinical phenomenon provoked by passive locomotion or movement of the visual environment only.It consists of pallor,tiredness,weakness,hypersalivation,nausea and emesis.
Diagnosis should be followed by adequate symptomatic treatment and management of underlying etiologies.The success of treatment of vertigo lies in regular follow up.