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Abstract：
BACKGROUND: Correctly diagnosing dizziness in children is essential for appropriate management; nevertheless, healthcare professionals face challenges due to children\'s limited ability to describe their symptoms and their cooperation during physical examination. The objective of this study is to describe the first 100 patients seen at a newly established pediatric vertigo center.
METHODS: This is a retrospective review of a consecutive series of 100 patients seen at our pediatric vertigo clinic in a tertiary referral center from August 2019 until June 2022. Comprehensive clinical data were collected. The diagnoses were established by 2 pediatric otolaryngologists based on validated diagnostic criteria. Trends in diagnosis, investigation, and treatment of these patients were analyzed.
RESULTS: A total of 100 children were included in the study. Vestibular migraine was the most common diagnosis (20%) followed by benign paroxysmal vertigo of childhood (14%). Eleven patients had combined pathologies. Fifteen out of 70 children (21%) had abnormal audiograms, 30 out of 48 children (62.5%) had abnormal vestibular testing, and 6 out of 31 (19%) patients had abnormal imaging. Fifty-one children received medical treatment, 23 received vestibular physiotherapy, and 9 patients had particle repositioning maneuvers; moreover, 17 of these patients received multimodal treatment.
CONCLUSIONS: Our analysis suggests that imaging and audiology testing have relatively low yield in the assessment of pediatric vertigo. On the other hand, vestibular testing detected a high proportion of abnormalities, such as saccadic pursuit, vertical nystagmus, central positional nystagmus, and abnormal directional preponderance, particularly associated with vestibular migraine. Given the complexity of diagnosing vertigo in children, it is critical to establish multidisciplinary specialized centers capable of providing accurate diagnosis and treatment for these children.
METHODS: This is a retrospective review of a consecutive series of 100 patients seen at our pediatric vertigo clinic in a tertiary referral center from August 2019 until June 2022. Comprehensive clinical data were collected. The diagnoses were established by 2 pediatric otolaryngologists based on validated diagnostic criteria. Trends in diagnosis, investigation, and treatment of these patients were analyzed.
RESULTS: A total of 100 children were included in the study. Vestibular migraine was the most common diagnosis (20%) followed by benign paroxysmal vertigo of childhood (14%). Eleven patients had combined pathologies. Fifteen out of 70 children (21%) had abnormal audiograms, 30 out of 48 children (62.5%) had abnormal vestibular testing, and 6 out of 31 (19%) patients had abnormal imaging. Fifty-one children received medical treatment, 23 received vestibular physiotherapy, and 9 patients had particle repositioning maneuvers; moreover, 17 of these patients received multimodal treatment.
CONCLUSIONS: Our analysis suggests that imaging and audiology testing have relatively low yield in the assessment of pediatric vertigo. On the other hand, vestibular testing detected a high proportion of abnormalities, such as saccadic pursuit, vertical nystagmus, central positional nystagmus, and abnormal directional preponderance, particularly associated with vestibular migraine. Given the complexity of diagnosing vertigo in children, it is critical to establish multidisciplinary specialized centers capable of providing accurate diagnosis and treatment for these children.
摘要：
背景：正确诊断儿童头晕对于适当管理至关重要；尽管如此，医疗保健专业人员面临的挑战，由于儿童的能力有限，以描述他们的症状和他们的合作在体检。这项研究的目的是描述在新成立的儿科眩晕中心看到的前100名患者。
方法：这是对2019年8月至2022年6月在三级转诊中心的儿科眩晕诊所连续100例患者的回顾性研究。收集综合临床资料。诊断由2名儿科耳鼻喉科医师根据有效的诊断标准确定。诊断趋势，调查,并对这些患者的治疗情况进行分析。
结果：共有100名儿童被纳入研究。前庭性偏头痛是最常见的诊断（20％），其次是儿童良性阵发性眩晕（14％）。11例患者有合并病理。70名儿童中有15名(21%)有异常听力图,48名儿童中有30名（62.5%）前庭检查异常，31例患者中有6例（19％）影像学异常。51名儿童接受了治疗，23人接受前庭理疗,9名患者进行了粒子重新定位操作；此外，其中17例患者接受了多模式治疗。
结论：我们的分析表明，影像学和听力学测试在评估小儿眩晕方面的效果相对较低。另一方面,前庭测试检测出高比例的异常，比如扫视追逐，垂直眼震,中央位置性眼震,和异常的方向性优势，特别是与前庭性偏头痛有关。鉴于诊断儿童眩晕的复杂性，建立能够为这些儿童提供准确诊断和治疗的多学科专业中心至关重要。
方法：这是对2019年8月至2022年6月在三级转诊中心的儿科眩晕诊所连续100例患者的回顾性研究。收集综合临床资料。诊断由2名儿科耳鼻喉科医师根据有效的诊断标准确定。诊断趋势，调查,并对这些患者的治疗情况进行分析。
结果：共有100名儿童被纳入研究。前庭性偏头痛是最常见的诊断（20％），其次是儿童良性阵发性眩晕（14％）。11例患者有合并病理。70名儿童中有15名(21%)有异常听力图,48名儿童中有30名（62.5%）前庭检查异常，31例患者中有6例（19％）影像学异常。51名儿童接受了治疗，23人接受前庭理疗,9名患者进行了粒子重新定位操作；此外，其中17例患者接受了多模式治疗。
结论：我们的分析表明，影像学和听力学测试在评估小儿眩晕方面的效果相对较低。另一方面,前庭测试检测出高比例的异常，比如扫视追逐，垂直眼震,中央位置性眼震,和异常的方向性优势，特别是与前庭性偏头痛有关。鉴于诊断儿童眩晕的复杂性，建立能够为这些儿童提供准确诊断和治疗的多学科专业中心至关重要。
