Epidemiology of Vestibular Impairments in a Pediatric Population

 

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Abstract

The purpose of this study was to report the prevalence of vestibular impairment (VI) in children (n = 2,528) referred for complete vestibular testing because of balance disorders (BD) or hearing loss (H). A VI was shown in 51.5% of the children tested (1,304/2,528). For BD (e.g., vertigo, dizziness, instability, delay in posturomotor development), VI was found in 36.5% (n = 379/1,037). The most frequent causes of BD with VI included inner ear malformation (13.5%), delay in posturomotor development (13.4%), hearing loss revealed with vertigo (3.9%), trauma (3.9%), vestibular neuritis (3.3%), meningitis (2.5%), Meniere-like syndrome (1.1%), BPPV posttrauma (1%), labyrinthitis (0.4%), and unknown etiology (19.6%). Normal responses to the complete battery of tests (n = 658, 63.5%) excluded a vestibular origin to BD, leading to other diagnoses: principally migraine (15.6%), ophthalmological disorders (15.1%), neurological disorders (including delay in posturomotor development; 14.4%), orthostatic hypotension, or somatoform dizziness (<1%). Of the children referred for hearing loss (n = 1,491), 68.5% were tested without cochlear implantation (CI; n = 1,022). In this group, 54.5% presented with VI (n = 557). This was mostly found in cytomegalovirus infection, inner ear malformation, and genetic syndromes. Profound hearing loss candidates for cochlear implants had complete bilateral vestibular loss in 20% and delay in posturomotor development, and 80% had partial or normal vestibular function and normal posturomotor development. VI was found after CI in 50% on the side of the implant (partial in 41% and complete in 9%). VI is present in 36.5% of children referred to our center for BDs and 54.5% for hearing loss. Vestibular testing permits ruling out peripheral VI and hence seeking other causes for BDs such as migraine and ophthalmological disorders and also helps lower the risk of inducing bilateral complete vestibular loss in CI protocols.

• References

• 1 Wiener-Vacher SR, Obeid R, Abou-Elew M. Vestibular impairment after bacterial meningitis delays infant posturomotor development. J Pediatr 2012; 161 (02) 246-51.e1
  CrossrefPubMedGoogle Scholar
• 2 Rine RM, Wiener-Vacher S. Evaluation and treatment of vestibular dysfunction in children. NeuroRehabilitation 2013; 32 (03) 507-518
  CrossrefPubMedGoogle Scholar
• 3 Li CM, Hoffman HJ, Ward BK, Cohen HS, Rine RM. Epidemiology of dizziness and balance problems in children in the United States: a population-based study. J Pediatr 2016; 171: 240-7.e1 , 3
  CrossrefPubMedGoogle Scholar
• 4 Niemensivu R, Pyykkö I, Wiener-Vacher SR, Kentala E. Vertigo and balance problems in children--an epidemiologic study in Finland. Int J Pediatr Otorhinolaryngol 2006; 70 (02) 259-265
  CrossrefPubMedGoogle Scholar
• 5 Humphriss RL, Hall AJ. Dizziness in 10 year old children: an epidemiological study. Int J Pediatr Otorhinolaryngol 2011; 75 (03) 395-400
  CrossrefPubMedGoogle Scholar
• 6 Filippopulos FM, Albers L, Straube A. , et al. Vertigo and dizziness in adolescents: risk factors and their population attributable risk. PLoS One 2017; 12 (11) e0187819
  CrossrefPubMedGoogle Scholar
• 7 Ketola S, Niemensivu R, Henttonen A, Appelberg B, Kentala E. Somatoform disorders in vertiginous children and adolescents. Int J Pediatr Otorhinolaryngol 2009; 73 (07) 933-936
  CrossrefPubMedGoogle Scholar
• 8 O'Reilly RC, Morlet T, Nicholas BD. , et al. Prevalence of vestibular and balance disorders in children. Otol Neurotol 2010; 31 (09) 1441-1444
  CrossrefPubMedGoogle Scholar
• 9 Jahn K, Langhagen T, Schroeder AS, Heinen F. Vertigo and dizziness in childhood - update on diagnosis and treatment. Neuropediatrics 2011; 42 (04) 129-134
  Article in Thieme ConnectPubMedGoogle Scholar
• 10 Langhagen T, Lehnen N, Krause E, Jahn K. Vertigo in children and adolescents. Part 1: Epidemiology and diagnosis of peripheral vestibular disorders [in German]. HNO 2013; 61 (09) 791-802 , quiz 803–804
  CrossrefPubMedGoogle Scholar
• 11 Gioacchini FM, Alicandri-Ciufelli M, Kaleci S, Magliulo G, Re M. Prevalence and diagnosis of vestibular disorders in children: a review. Int J Pediatr Otorhinolaryngol 2014; 78 (05) 718-724
  CrossrefPubMedGoogle Scholar
• 12 Langhagen T, Albers L, Heinen F. , et al. Period prevalence of dizziness and vertigo in adolescents. PLoS One 2015; 10 (09) e0136512
  CrossrefPubMedGoogle Scholar
• 13 Raucci U, Vanacore N, Paolino MC. , et al. Vertigo/dizziness in pediatric emergency department: five years' experience. Cephalalgia 2016; 36 (06) 593-598
  CrossrefPubMedGoogle Scholar
• 14 Sommerfleck PA, González Macchi ME, Weinschelbaum R, De Bagge MD, Bernáldez P, Carmona S. Balance disorders in childhood: main etiologies according to age. Usefulness of the video head impulse test. Int J Pediatr Otorhinolaryngol 2016; 87: 148-153
  CrossrefPubMedGoogle Scholar
• 15 Lüscher M, Theilgaard S, Edholm B. Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness. J Laryngol Otol 2014; 128 (02) 128-133
  CrossrefPubMedGoogle Scholar
• 16 Jacot E, Wiener-Vacher S. Potential value of vestibular evoked myogenic potentials in paediatric neuropathies. J Vestib Res 2008; 18 (04) 231-237
  PubMedGoogle Scholar
• 17 Cushing SL, Gordon KA, Rutka JA, James AL, Papsin BC. Vestibular end-organ dysfunction in children with sensorineural hearing loss and cochlear implants: an expanded cohort and etiologic assessment. Otol Neurotol 2013; 34 (03) 422-428
  CrossrefPubMedGoogle Scholar
• 18 Bernard S, Wiener-Vacher S, Van Den Abbeele T, Teissier N. Vestibular disorders in children with congenital cytomegalovirus infection. Pediatrics 2015; 136 (04) e887-e895
  CrossrefPubMedGoogle Scholar
• 19 Noel-Petroff N. Cent Syndromes ORL Avec Surdite. France: EDP Sante; 2014
  Google Scholar
• 20 Jacot E, Van Den Abbeele T, Debre HR, Wiener-Vacher SR. Vestibular impairments pre- and post-cochlear implant in children. Int J Pediatr Otorhinolaryngol 2009; 73 (02) 209-217
  CrossrefPubMedGoogle Scholar
• 21 Wiener-Vacher SR, Wiener SI. Video head impulse tests with a remote camera system: normative values of semicircular canal vestibulo-ocular reflex gain in infants and children. Front Neurol 2017; 8: 434
  CrossrefPubMedGoogle Scholar
• 22 Ndiaye IC, Rassi SJ, Wiener-Vacher SR. Cochleovestibular impairment in pediatric Cogan's syndrome. Pediatrics 2002; 109 (02) E38
  CrossrefPubMedGoogle Scholar
• 23 Lempert T, Olesen J, Furman J. , et al. Vestibular migraine: diagnostic criteria. J Vestib Res 2012; 22 (04) 167-172
  CrossrefPubMedGoogle Scholar
• 24 Basser LS. Benign paroxysmal vertigo of childhood. A variety of vestibular neuronitis. Brain 1964; 87: 141-152
  CrossrefPubMedGoogle Scholar
• 25 Sennaroglu L, Saatci I. A new classification for cochleovestibular malformations. Laryngoscope 2002; 112 (12) 2230-2241 .PMID:12461346
  CrossrefPubMedGoogle Scholar
• 26 Guerra-Jiménez G, Arenas Rodríguez A, Falcón González JC, Pérez Plasencia D, Ramos Macías Á. Epidemiology of vestibular disorders in the otoneurology unit. Acta Otorrinolaringol Esp 2017; 68 (06) 317-322
  CrossrefPubMedGoogle Scholar
• 27 Langhagen T, Landgraf MN, Huppert D, Heinen F, Jahn K. Vestibular migraine in children and adolescents. Curr Pain Headache Rep 2016; 20 (12) 67
  CrossrefPubMedGoogle Scholar
• 28 Anoh-Tanon MJ, Bremond-Gignac D, Wiener-Vacher SR. Vertigo is an underestimated symptom of ocular disorders: dizzy children do not always need MRI. Pediatr Neurol 2000; 23 (01) 49-53
  CrossrefPubMedGoogle Scholar
• 29 Gaertner C, Bucci MP, Ajrezo L, Wiener-Vacher S. Binocular coordination of saccades during reading in children with clinically assessed poor vergence capabilities. Vision Res 2013; 87: 22-29
  CrossrefPubMedGoogle Scholar
• 30 Lee JD, Kim CH, Hong SM. , et al. Prevalence of vestibular and balance disorders in children and adolescents according to age: a multi-center study. Int J Pediatr Otorhinolaryngol 2017; 94: 36-39
  CrossrefPubMedGoogle Scholar
• 31 Langhagen T, Schroeder AS, Rettinger N, Borggraefe I, Jahn K. Migraine-related vertigo and somatoform vertigo frequently occur in children and are often associated. Neuropediatrics 2013; 44 (01) 55-58
  Article in Thieme ConnectPubMedGoogle Scholar
• 32 Wiener-Vacher SR, Hamilton DA, Wiener SI. Vestibular activity and cognitive development in children: perspectives. Front Integr Nuerosci 2013; 7: 92
  PubMedGoogle Scholar