소아 어지럼의 원인과 임상 양상
Etiology and Clinical Characteristics of Pediatric Dizziness
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Background and Objectives Dizziness is not uncommon in children. The etiology of dizzinessvaries according to different studies due to different methods of examination or characteristicsof the dizziness center. To assess meaningful causes of dizziness in children, a multidisciplinaryapproach would be needed. The purpose of this study was to analyze the mainpathologies associated with vertigo and dizziness in children, paying particular attention torecent diagnostic advances with a multidisciplinary approach. Subjects and Method A total of 73 children, aged between 4-18 years, who visited thePediatric Dizziness Clinic of the University Hospital from January 2016 to June 2016 were includedin this study. Medical records were reviewed retrospectively. All of the subjects wereexamined by history, questionnaires, physical examinations, electrocardiogram, hematologictests, brain MRI scan, audiogram and vestibular function tests. Patients who had orthostaticsymptoms additionally underwent a tilt table test, and in selective cases, a caloric and vestibularevoked myogenic potential tests as well. Results Vestibular migraine (VM) and benign paroxysmal vertigo of childhood (BPVC)were found in 35.6% and 27.4% of the children with dizziness, respectively. The incidence oforthostatic hypotension and postural orthostatic tachycardia syndrome were 12.3% each, bothof which are higher than other previous reports. Other causes were Meniere’s disease, benignparoxysmal positional vertigo, vestibular neuritis and so on. Conclusion VM and BPVC were the most common causes of pediatric dizziness. Also, theincidence of orthostatic dizziness was rather high in pediatric population. The evaluation of dizzinessin children should include a thorough check of history (questionnaire), neurotologicalexamination, vestibular function tests and a tilt table test.
Abstract
Background and Objectives Dizziness is not uncommon in children. The etiology of dizzinessvaries according to different studies due to different methods of examination or characteristicsof the dizziness center. To assess meaningful causes of dizziness in children, a multidisciplinaryapproach would be needed. The purpose of this study was to analyze the mainpathologies associated with vertigo and dizziness in children, paying particular attention torecent diagnostic advances with a multidisciplinary approach. Subjects and Method A total of 73 children, aged between 4-18 years, who visited thePediatric Dizziness Clinic of the University Hospital from January 2016 to June 2016 were includedin this study. Medical records were reviewed retrospectively. All of the subjects wereexamined by history, questionnaires, physical examinations, electrocardiogram, hematologictests, brain MRI scan, audiogram and vestibular function tests. Patients who had orthostaticsymptoms additionally underwent a tilt table test, and in selective cases, a caloric and vestibularevoked myogenic potential tests as well. Results Vestibular migraine (VM) and benign paroxysmal vertigo of childhood (BPVC)were found in 35.6% and 27.4% of the children with dizziness, respectively. The incidence oforthostatic hypotension and postural orthostatic tachycardia syndrome were 12.3% each, bothof which are higher than other previous reports. Other causes were Meniere’s disease, benignparoxysmal positional vertigo, vestibular neuritis and so on. Conclusion VM and BPVC were the most common causes of pediatric dizziness. Also, theincidence of orthostatic dizziness was rather high in pediatric population. The evaluation of dizzinessin children should include a thorough check of history (questionnaire), neurotologicalexamination, vestibular function tests and a tilt table test.
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