Unveiling the Diagnosis of Pediatric Dizziness in a Tertiary Care Hospital: The Complementary Role of Vestibular and Neurological Evaluations.

Abstract

Introduction  Pediatric dizziness is not a rare symptom, and it has a significant impact on the child's psychophysical wellbeing and quality of life. There are diverse etiologies of dizziness in children; however, it is challenging to diagnose. Vestibular and neurological assessments are crucial in the diagnosis of pediatric dizziness. Objective  To outline the most common etiologies of dizziness in children and to investigate the complementary role of the vestibular and neurological evaluations in the assessment of dizzy children. Methods  We conducted a case-control study including 40 children with a complaint of dizziness and 40 healthy children as the control group. We assessed their full medical history audiovestibular function through pure tone audiometry, videonystagmography examination, cervical vestibular evoked myogenic potentials, the results of video head impulse tests, as well as their electroencephalograms and brain magnetic resonance imaging scans. Results  The mean age of the 40 children who were presented with dizziness was of 13.65 years. Migraine was found to be the commonest cause of vertigo (27.5%), while benign paroxysmal vertigo of childhood was detected in 17.5%, and central nervous system causes, in 12.5%. The diagnosis could not be ascertained in 9 (22.5%) patients. Conclusion  The diagnosis of the etiologies of pediatric dizziness is challenging; however, detailed medical history, a comprehensive examination, a multidisciplinary approach, along with full vestibular and neurological assessments, are essential to reach an accurate diagnosis.