The impact of follow-up on etiological classification of pediatric vertigo

Božanić Urbančič, Nina (author), Mladenov, Dejan (author), Battelino, Saba (author)

Background: Vertigo and dizziness in children represent diagnostically challenging conditions with heterogeneous etiologies. At initial presentation, a substantial proportion of pediatric patients remain without a definitive etiological diagnosis. Evidence on the impact of longitudinal follow-up on etiological classification in pediatric vertigo is limited. Methods: This observational cohort study uses prospectively collected clinical data. Children aged 1-17 years who presented to a tertiary ENT clinic with vertigo and/or dizziness between 2015 and 2020 were systematically enrolled and followed. The present study represents a retrospective revision of a previously published cohort of 257 children. In 2025, extended follow-up data were reviewed to reassess etiological classification using the same diagnostic categories as in the original analysis. Descriptive statistics were applied to compare etiological distributions at initial evaluation and after follow-up revision. Results: After data revision, the proportion of children with unclassified etiology decreased from 44% to 10%. Central etiologies accounted for 35% of cases, peripheral vestibular disorders for 18%, hemodynamic causes for 16%, psychogenic etiologies for 10%, and other specific causes for 7%. Follow-up duration ranged from 0 to 132 months (mean 17.6 months; median 4.5 months). Diagnostic investigations were frequently performed; however, the etiological yield of certain tests, particularly cranial computed tomography, was low. Conclusions: Extended follow-up significantly improves etiological classification in children with vertigo and dizziness, demonstrating that diagnostic uncertainty at initial presentation often reflects evolving clinical phenotypes rather than the absence of an underlying disorder. A longitudinal, clinically guided, and multidisciplinary approach is essential to enhance diagnostic accuracy and optimize the use of diagnostic investigations in pediatric vertigo.

• Language: English
• Keywords: dizziness, etiology, follow-up, migraine, pediatric vertigo, vestibular disorders
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: 13 str.
• Numbering: Vol. 13, iss. 3, art. 376
• PID: 20.500.12556/RUL-182563
• UDC: 616.21
• ISSN on article: 2227-9067
• DOI: 10.3390/children13030376
• COBISS.SI-ID: 277870339
• Publication date in RUL: 19.05.2026

Record is a part of a journal

• Title: Children
• Shortened title: Children
• Publisher: MDPI
• ISSN: 2227-9067
• COBISS.SI-ID: 523029017

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: omotica, etiologija, sledenje, migrena, pediatrična vrtoglavice, vrtoglavica pri otrocih

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0307
• Name: Rak glave in vratu - analiza bioloških značilnosti in poskus izboljšanja zdravljenja