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  • Title: [Vertigo and dizziness in child: a clinical analysis in 120 cases].
    Author: Gao F, Gong SS.
    Journal: Zhonghua Nei Ke Za Zhi; 2024 Jul 01; 63(7):680-685. PubMed ID: 38951092.
    Abstract:
    Objective: To investigate the disease composition, clinical features, diagnosis, and treatment characteristics of vertigo in children. Methods: A total of 120 children with vertigo diagnosed and treated in the Department of Otorhinolaryngology, Children's Hospital, Capital Institute of Pediatrics in Beijing from February 2018 to February 2022 were retrospectively analyzed to explore the clinical characteristics of common peripheral vertigo in children and to summarize the experience of diagnosis and treatment. Results: The etiological composition of 120 cases of vertigo in children are as follows: 63 (52.5%) cases of vestibular migraine of childhood (VMC), 19 (15.8%) of recurrent vertigo of childhood (RVC), 11 (9.2%) of probable vestibular migraine of childhood (PVMC), 10 (8.3%) of secretory otitis media (SOM), 6 (5.0%) of persistent postural-perceptual dizziness (PPPD), 4 (3.3%) of benign paroxysmal positional vertigo (BPPV), 2 (1.7%) of vestibular neuritis (VN), 2 (1.7%) of Meniere's disease (MD), 2 (1.7%) of inner ear malformation (IEM), and 1 (0.8%) of vestibular paroxysmal syndrome (VP).The major cause of vertigo in children of different ages was different. SOM was the most important cause in preschool children, followed by RVC and VMC; VMC was the most important cause in school-age children, followed by RVC; and MD and BPPV were exclusive found in adolescents. The incidence rate of PPPD was higher in adolescents than in preschool and school-age children. Children with vertigo had good prognosis in general. Conclusions: VMC, RVC and SOM are the most common causes in vertigo in children, and their proportion was different in different aged children. Transforming abstract feelings into specific information is the skill required for collecting medical history of children with vertigo. Considering the age and cooperation of children, appropriate hearing and vestibular examination techniques are recommended. We should pay more attention to the mental health of children with vertigo and their parents. 目的： 了解儿童眩晕的病因构成、临床表现及诊疗特点。 方法： 病例系列研究。回顾性分析2018年2月至2022年2月首都儿科研究所附属儿童医院耳鼻喉科诊治的120例眩晕患儿的临床资料，探讨儿童常见眩晕的临床特点、总结诊疗经验。 结果： （1）120例儿童眩晕的病因构成：儿童前庭性偏头痛（VMC）63例（52.5%）、儿童复发性眩晕（RVC）19例（15.8%），可能性前庭性偏头痛（PVMC）11例（9.2%），分泌性中耳炎（SOM）10例（8.3%），持续性姿势-感知性头晕（PPPD）6例（5.0%）、良性阵发性位置性眩晕（BPPV）4例（3.3%），前庭神经炎（VN）2例（1.7%），梅尼埃病（MD）2例（1.7%），内耳先天性发育畸形2例（1.7%）、前庭阵发症（VP）1例（0.8%）。（2）不同的年龄阶段，儿童眩晕的病因构成不同，学龄前儿童最主要的是SOM，之后是RVC和VMC；学龄儿童则主要是VMC，之后是RVC；相较于其他年龄段，青少年期MD、BPPV，尤其是PPPD发病率更高。（3）眩晕患儿的整体预后较好。 结论： 眩晕患儿病因以VMC、RVC、SOM为主，在不同的年龄阶段病因不同。采集眩晕患儿病史的技巧是将抽象的感受转化为具体的事项。根据儿童的年龄和配合度，选择适合的听力和前庭检查，并关注眩晕患儿及家长的心理健康，将有助于临床诊治。.
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