Unveiling the Diagnosis of Pediatric Dizziness in a Tertiary Care Hospital: The Complementary Role of Vestibular and Neurological Evaluations

TL;DR

This study explores the causes of dizziness in children and shows how combining vestibular and neurological tests helps in accurate diagnosis.

Contribution

The study highlights the diagnostic value of combining vestibular and neurological evaluations in pediatric dizziness.

Findings

Migraine was the most common cause of dizziness in children (27.5%).

Benign paroxysmal vertigo of childhood was found in 17.5% of cases.

Central nervous system causes were identified in 12.5% of patients.

Abstract

Introduction
 Pediatric dizziness is not a rare symptom, and it has a significant impact on the child's psychophysical wellbeing and quality of life. There are diverse etiologies of dizziness in children; however, it is challenging to diagnose. Vestibular and neurological assessments are crucial in the diagnosis of pediatric dizziness.

Objective
 To outline the most common etiologies of dizziness in children and to investigate the complementary role of the vestibular and neurological evaluations in the assessment of dizzy children.

Methods
 We conducted a case-control study including 40 children with a complaint of dizziness and 40 healthy children as the control group. We assessed their full medical history audiovestibular function through pure tone audiometry, videonystagmography examination, cervical vestibular evoked myogenic potentials, the results of video head impulse tests, as well as their electroencephalograms and brain magnetic resonance imaging scans.

Results
 The mean age of the 40 children who were presented with dizziness was of 13.65 years. Migraine was found to be the commonest cause of vertigo (27.5%), while benign paroxysmal vertigo of childhood was detected in 17.5%, and central nervous system causes, in 12.5%. The diagnosis could not be ascertained in 9 (22.5%) patients.

Conclusion
 The diagnosis of the etiologies of pediatric dizziness is challenging; however, detailed medical history, a comprehensive examination, a multidisciplinary approach, along with full vestibular and neurological assessments, are essential to reach an accurate diagnosis.

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