Dizziness in 10 year old children: An epidemiological study

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Abstract

Objective

Current data about the prevalence and characteristics of dizziness in the paediatric population is very limited and the generalisability of extant studies to the UK population has not been explored. Our study aims to provide a robust estimate of the prevalence of dizziness in 10 year old children in the UK, to describe the characteristics of this dizziness and to explore whether this dizziness is socially patterned.

Methods

Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) was analysed (N = 13,988). A total of 6965 of these children attended for a balance assessment session at age 10. Those who reported rotary vertigo were interviewed about their symptoms. Logistic regression was used to explore whether dizziness at age 10 is socially patterned.

Results

A total of 400 children reported rotary vertigo, giving a prevalence estimate of 5.7% [CI 5.2, 6.3%]. 13.1–20.6% of children reported experiencing their dizziness between 1 and 4 times a week (depending on the symptom). 51.5% of children had to stop what they were doing because of the dizziness making them feel unwell. A total of 60% of children reported headache as an accompanying symptom, tentatively suggesting a diagnosis of migraine, although there was no association between reports of headache and a maternal family history of migraine. 20.3% of children with dizziness also reported tinnitus and 17.3% reported that their hearing changed when they were dizzy.

Conclusions

Dizziness in 10 year old children is not uncommon and in about half limits current activities. Rotary vertigo is commonly accompanied by dizziness of another description and also by headache. There is no evidence that dizziness at this age is socially patterned.

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)

  • Royal College of Physicians, Hearing and balance disorders: achieving excellence in diagnosis and management. Report of...
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      Citation 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.

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