Prevalence, Clinical Profile, and Diagnosis of Dizziness in Pediatric Population
30 September 2019 (online)
Background Children with giddiness are challenging group of individuals. The diagnosis and management of vertiginous symptoms are often ignored most likely due to the difficulty that young children have in describing their symptoms. These cases are, hence, generally treated with indifference by clinicians.
Aim To ascertain the prevalence of vestibular disorders in 0 to 18 years of age group presenting to the Department of ENT, during a period from January 1, 2018 to August 31, 2018 and to systematically analyze the signs, symptoms, and investigations of children presenting with vertigo and make a diagnosis.
Methods This was a prospective observational clinical study. Thirty-nine children who presented with dizziness during the stated time period were taken for the study after consent by parents. They underwent detailed neurotological evaluation.
Results The prevalence of the pediatric vertigo in the study population is 0.007% (39/5850). There were 25 male and 14 female children. There was one child (2.5%) in 0 to 6 years, 24 children (61.5%) in 6 to 12 years, and 14 children (35.8%) in 12 to 18 years age group. Among them, 13 children (33.3%) presented with symptoms of head rotatory vertigo, 18 (46.2%) with surrounding rotatory vertigo, and eight (20.5%) had symptoms of imbalance and heaviness head. Among these, two children (0.05%) had unilateral profound hearing loss, while one child (0.02%) had unilateral minimal hearing loss, and retrocochlear pathology was diagnosed in one child. Vestibular evaluation with electronystagmogram was performed in 25 children (64%) out of which 12 (30.7%) had hypoactive labyrinth (bilateral or unilateral) and one (0.03%) had hyperactive labyrinth (bilateral or unilateral). Two children (0.05%) had abnormal subjective visual vertical. Among the various diagnoses made, the four main pathology found in our study were vestibular migraine in 17 (43.5%), vasovagal syncope in six (15.4%), otolithic dysfunction in three (7.7%), and posttraumatic concussion in three (7.7%) patients.
Conclusion In our study, we have found that the prevalence of pediatric giddiness to be 0.007% and the most common diagnosis made was vestibular migraine. It is quite feasible and essential to evaluate children with vertigo and dizziness systematically to make a relevant clinical diagnosis, which helps in the proper management of these patients and also allay anxiety in parents.