Balance disorders in childhood: Main etiologies according to age. Usefulness of the video head impulse test

Int J Pediatr Otorhinolaryngol. 2016 Aug:87:148-53. doi: 10.1016/j.ijporl.2016.06.020. Epub 2016 Jun 7.

Abstract

Balance disorders are common in adult patients but less usual in the pediatric population. When this symptomatology appears in children it is a cause for concern, both for parents and health-care professionals.

Objectives: To explain the balance disorders in children describing a case series and to discuss the main etiologies found according to age.

Study design: A retrospective, observational, descriptive, and cross-sectional study was conducted.

Population: Patients aged 1-18 years who consulted because of balance disorders at the otolaryngology department of a pediatric tertiary-care hospital between March 2012 and July 2015.

Results: Two hundred and six patients were included in the study. Median age was 10 years. The most common diagnoses were vestibular migraine in 21.8% of the children, ataxia in 9.22%, benign paroxysmal vertigo of childhood in 7.77%, and post-traumatic vertigo in 6.31%.Overall, 61 videonystagmographies- of which 46 were normal - and 55 video head impulse tests - which were normal in 45 and showed abnormalities in the vestibulo-ocular reflex gain in 10 - were performed.

Conclusions: In a child with balance disorders, the medical history and neurotological examination are essential. Vestibular migraine is the most commonly found disorder in every age group, and most of the patients have a family history of migraine. Ancillary studies, especially the video head-impulse test, provide important data to confirm the diagnosis.

Keywords: Balance-disorder; Childhood; Video-head-impulse-test.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Ataxia / complications
  • Ataxia / physiopathology*
  • Benign Paroxysmal Positional Vertigo / complications
  • Benign Paroxysmal Positional Vertigo / physiopathology*
  • Central Nervous System Neoplasms / complications
  • Central Nervous System Neoplasms / physiopathology*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Head Impulse Test
  • Humans
  • Infant
  • Labyrinthitis / complications
  • Labyrinthitis / physiopathology*
  • Male
  • Migraine Disorders / complications
  • Migraine Disorders / physiopathology*
  • Otitis Media with Effusion / complications
  • Otitis Media with Effusion / physiopathology*
  • Postural Balance*
  • Reflex, Vestibulo-Ocular
  • Retrospective Studies
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology*
  • Vertigo / complications
  • Vertigo / physiopathology
  • Vestibular Diseases
  • Vestibular Function Tests