Indicators of pediatric peripheral vestibular disorder : a retrospective study in a tertiary referral center

Božanić Urbančič, Nina (avtor), Vozel, Domen (avtor), Kordiš, Špela (avtor), Hribar, Manja (avtor), Urbančič, Jure (avtor), Battelino, Saba (avtor)

Objectives: This study aims to present characteristics of pediatric patients with peripheral vertigo and dizziness and their clinical workup results in the tertiary otorhinolaryngology center. We wanted to investigate whether the detailed history could replace the extensive vestibular testing and whether the clinical presentation could guide the first contact physician to appropriately directed specialist referral. Methods: Retrospective case review of consecutive pediatric vertigo and dizziness patients referred to the tertiary otorhinolaryngology center from 2015 to 2020. The data about the signs and symptoms of vertigo and dizziness and the results of audiological and vestibular tests were collected. Results: Of 257 children aged 10.9±4.3 years (R: 1–17 years), 32 (12.5%) had peripheral, and 49 (19%) had central vertigo and dizziness. Acute vestibulopathy was diagnosed in 22/257 (8.5%) children, sudden sensorineural hearing loss and benign paroxysmal positional vertigo in 5/257 (2%) children each. 60% of children with peripheral vertigo and dizziness had emesis, and 55.6% had nausea. 8% of children had spontaneous horizontal-rotatory nystagmus that followed Alexander’s law. Goodman and Kruskal’s л for determining whether the type of nystagmus could predict the type of vertigo and dizziness (central or peripheral) was 0.481 (p = 0.001). 12/26 (60%) of children with peripheral vertigo and dizziness had emesis compared to 14 (30.04%) children without emesis, a difference in proportions of 0.296 (p = 0.024, chi-square test of homogeneity). Binomial logistic regression to ascertain the effects of duration, nausea and emesis on the likelihood of the presence of peripheral vertigo was statistically significant (χ2(3) = 10.626, p = 0.014). Conclusion: Unlike adults, peripheral vestibular causes of vertigo and dizziness in children may be rare but have the same typical signs and symptoms. The detailed history and careful clinical examination are crucial in differentiating between peripheral and central causes. This guides the first contact physician for further referral to appropriate specialists included in a multidisciplinary workup. Namely, nausea, emesis, horizontal nystagmus and a longer duration of symptoms in a child with vertigo and dizziness indicate a peripheral etiology. Therefore, a referral to an otorhinolaryngologist is reasonable.

• Jezik: Angleški jezik
• Ključne besede: vertigo, dizziness, inner ear, saccule, utricle, hearing loss, semicircular canals
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2022
• Št. strani: 8 str.
• Številčenje: Vol. 159, art. 111221
• PID: 20.500.12556/RUL-139771
• UDK: 1-016.05
• ISSN pri članku: 1872-8464
• DOI: 10.1016/j.ijporl.2022.111221
• COBISS.SI-ID: 115111683
• Datum objave v RUL: 07.09.2022

Gradivo je del revije

• Naslov: International journal of pediatric otorhinolaryngology
• Založnik: Elsevier
• ISSN: 1872-8464
• COBISS.SI-ID: 23182085

Licence

• Licenca: CC BY-NC-ND 4.0, Creative Commons Priznanje avtorstva-Nekomercialno-Brez predelav 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by-nc-nd/4.0/deed.sl
• Opis: Najbolj omejujoča licenca Creative Commons. Uporabniki lahko prenesejo in delijo delo v nekomercialne namene in ga ne smejo uporabiti za nobene druge namene.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: otorinolaringologija, vertigo, slabost, uho, izguba sluha, test vestibularne funkcije, pediatrija

Projekti

• Financer: Drugi - Drug financer ali več financerjev
• Program financ.: University Medical Centre Ljubljana
• Številka projekta: 20200036

• Financer: ARRS - Agencija za raziskovalno dejavnost Republike Slovenije
• Številka projekta: P3-0374
• Naslov: Preiskovanje orofacialnega področja za izboljšanje oralnega zdravja