Dizziness in 10 year old children: An epidemiological study
Introduction
Balance problems and dizziness are thought to be rare in children. Although there have been several previous studies on the prevalence of vertigo and dizziness in adults, giving values of 23% for dizziness (1 month prevalence) [1], and of between 7.4% and 7.8% for vestibular vertigo (life-time prevalence) [2], [3], the literature in children is scant. The best evidence in this area comes from two previous population based studies. A cross-sectional study based in Scotland which sampled 2165 school children (aged 5–15 years) found the 1-year prevalence for a single episode of rotary vertigo to be 18% with the prevalence falling to 5% for at least 3 episodes [4]. More recently, Niemensivu et al. [5] sampled 1050 children aged 1–15 years in Finland and estimated the life-time prevalence of vertigo or dizziness to be 8% and that for poor balance or disequilibrium to be 2%. However, the relatively small sample sizes and the methods used for recruiting these samples raise questions about the generalisability of these values to the UK population as a whole.
It is important that a valid estimate of prevalence of dizziness in children is determined when one considers that such symptoms could have adverse psychosocial associations such as anxiety and avoidance behaviour [6], with possible consequences for a child's educational attainment and quality of life. It is also important that clinicians understand the characteristics of dizziness in children so that appropriate interventions can be offered.
It has been well-established that many health-related outcomes are socially patterned [7], [8]. Of relevance to the present study is the social patterning of balance outcomes in children. Poresky and Henderson [9] found that the motor development of 2 year old children was associated with family socio-economic status (SES) and McPhillips and Jordan-Black [10] found a similar effect in older children. The authors are not aware, however, of studies that have looked specifically at the relationship between SES and dizziness in children. Although previous studies on adults have found social advantage to be associated with better balance [11], [12], an independent effect of SES on dizziness has not been established [2], [11].
The present study seeks to add to the literature presented above using data collected as part of a UK large-scale population-based prospective study, the Avon Longitudinal Study of Parents and Children (ALSPAC). Specifically this study aims to estimate the prevalence of dizziness in 10 year old children, to describe the characteristics of these symptoms and to explore whether dizziness at this age is socially patterned.
Section snippets
Methods
The study group was taken from the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC is a birth cohort consisting of children born to women who were resident in the former Avon region of the UK and who were due to give birth between April 1991 and December 1992 (n = 14,541 giving rise to 13,988 live infants at 1 year). Further details of this study have been published elsewhere [13] and can be found on its website (www.bristol.ac.uk/alspac). The ALSPAC cohort is considered to be
The sample
Of the 6965 children who attended the balance session at age 10, 3456 were boys (49.6%).
Comparison of sample to cohort
The 7168 ALSPAC children who attended for the age 10 assessment were compared with the remainder of the cohort who did not attend this session (n = 6793). χ2 tests revealed our sample to be characterised by higher proportions of: females, those who had any breast feeding, children with lower parity, children with a white ethnic background, those in owned/mortgaged homes, higher maternal educational
Discussion
This paper provides a robust estimate of the prevalence of dizziness in 10 year old children in the UK. Dizziness in 10 year old children was found to be not uncommon with a prevalence of 5.7% [CI 5.2, 6.3%]. Just over half of these children reported their dizziness to be severe enough to stop their current activity.
The ALSPAC prevalence estimate is lower than the 8% found by Niemensivu et al. [5] and is also considerably lower than the 1 year prevalence for one previous episode of vertigo of
Conclusion
A population-based birth cohort study was used to estimate the prevalence of dizziness in 10 year old children in the UK. Dizziness was found to be not uncommon, the prevalence being 5.7% [CI 5.2, 6.3%]. Clinicians therefore need to be aware that approximately 1 in 20 children will experience dizziness at or before the age of 10. A total of 60% of children reported headache as an accompanying symptom, supporting previous reports that the diagnosis of migraine is relatively common in children,
Acknowledgements
We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. We are also grateful to Professor Linda Luxon who devised the questions used in the structured interviews. The UK Medical Research Council (grant ref: 74882), the Wellcome Trust (grant ref: 076467)
References (23)
- et al.
Vertigo and balance problems in children – An epidemiologic study in Finland
International Journal of Pediatric Otorhinolaryngology
(2006) - et al.
Etiology of vertigo in children
International Journal of Pediatric Otorhinolaryngology
(2007) - et al.
Paroxysmal vertigo in children—an epidemiological study
International Journal of Pediatric Otorhinolaryngology
(1999) - et al.
Various causes and clinical characteristics in vertigo in children with normal eardrums
International Journal of Pediatric Otorhinolaryngology
(2003) - et al.
A simplified diagnostic approach to dizziness in children
Pediatric Neurology
(2003) - et al.
Vertigo in childhood: a clinical experience
International Journal of Pediatric Otorhinolaryngology
(2006) - et al.
Prevalence and presentation of dizziness in a general practice community sample of working age people
British Journal of General Practice
(1998) - et al.
Epidemiology of vestibular vertigo. A neurotologic survey of the general population
Neurology
(2005) - et al.
Screening for Meniere's Disease in the general population—the needle in the haystack
Acta Oto-Laryngologica
(2008) - et al.
Paroxysmal vertigo as a migraine equivalent in children: a population-based study
Cephalagia
(1995)
Cited by (62)
Translation, Cross-Cultural Adaptation, and Validation of the Polish Version of the Dizziness Handicap Inventory
2022, Value in Health Regional IssuescVEMPs and oVEMPs normative data in Malaysian preschool and primary school-aged children
2020, International Journal of Pediatric OtorhinolaryngologyAcute vestibular syndrome and hearing loss mimicking labyrinthitis as initial presentation of multiple sclerosis
2020, International Journal of Pediatric OtorhinolaryngologyAssociation between vertigo, cognitive and psychiatric conditions in US children: 2012 National Health Interview Survey
2020, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :In the studies of children from Scotland, the screening question reported on is for ‘dizziness attacks’, after interviewing a sample of children who reported dizziness attacks, the authors report a prevalence of paroxysmal vertigo of 2.6%, which is closer to that reported in the present study [2,4]. In a sample of 10 year olds in the UK dizziness was reported by 5.7%, but on further questioning only 59% of those reported the dizziness was like ‘objects turning or spinning around you’, suggesting the vertigo prevalence was closer to 3.4% [3]. These differences in methodology and reported prevalence highlight the difficulty in assessing vertigo, which even in adults can be difficult to assess, and is even more difficult to evaluate in children who may not have the language or descriptive skills required to provide a good history.
Experience from the First Paediatric Vestibular and Balance Clinic in a Multiracial Asian Setting
2024, Indian Journal of Otolaryngology and Head and Neck SurgeryThe global prevalence of vestibular dysfunction in children and adolescents: a systematic review and meta-analysis
2023, European Archives of Oto-Rhino-Laryngology