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ÇOCUKLUK ÇAĞINDA VERTİGO: BAŞ DÖNMESİ OLAN ÇOCUKLARI NASIL DEĞERLENDİRELİM?

Year 2021, Volume: 28 Issue: 4, 627 - 634, 30.12.2021
https://doi.org/10.17343/sdutfd.998278

Abstract

Amaç
Çocukluk çağında vertigo, geniş ayırıcı tanısı olan bir
yakınmadır. Bu çalışmanın amacı, vertigo şikayeti ile
başvuran çocuk hastaların klinik özelliklerini belirlemek
ve ayırıcı tanılarını değerlendirmektir.
Gereç ve Yöntem
Bu retrospektif çalışmada, Ocak 2018-Ocak 2021 tarihleri
arasında Çocuk Nöroloji Polikliniğine, vertigo
şikayeti ile başvuran yüz hastanın tıbbi kayıtları incelendi.
Hastalar yaş, cinsiyet, aile öyküsü, semptomların
süresi, atak sıklığı, provoke edici faktörler, eşlik
eden semptomlar, fizik muayene, laboratuvar bulguları
ve aldığı tanı açısından değerlendirildi.
Bulgular
Ortalama yaş 12.39 idi. Hastaların çoğunluğu (%64)
erkekti. Vertigonun farklı nedenleri vardı, ancak en
yaygın olan tanı, enfeksiyon (%34) ve psikojenik vertigo
(%25) idi. Diğer sık nedenler arasında ortostatik
hipotansiyon (%16) ve vitamin B12 eksikliği (%9)
saptandı. Hastaların çoğunda semptom süresi bir aydan
kısaydı ve ataklar genel olarak her gün görüldü.
Hastalar ataklarını, çevrenin hareketi (%61), dönme
(%27), dengesizlik (%20) ve diğerleri olarak tanımladı.
En sık eşlik eden şikayetler, yorgunluk (%60) ve
baş ağrısı (%54) olarak belirlendi. Laboratuvar verileri
değerlendirildiğinde; dokuz hastada vitamin B12 eksikliği
saptandı; diğer tüm testler normal aralıktaydı.
Otuz dokuz hastaya kraniyal manyetik rezonans görüntüleme
yapılmıştı, 2 hastada anormal bulgu saptandı
ve anormal bulgulardan sadece biri vertigodan
sorumluydu.
Sonuç
Çocuklarda vertigo, hem ebeveynlerde hem de doktorlarda
endişe duygusu yaratır ve çoğunlukla fazla
laboratuvar ve görüntüleme incelemesine yol açar.
Gereksiz araştırmalardan kaçınmak için değerlendirmeye
ayrıntılı öykü ve kapsamlı fiziksel muayene ile
başlanmalıdır. Vertigoya sebep olan ciddi durumlar
nadirdir ve dikkatli klinik muayene ile tespit edilebilir.

References

  • 1. Korkmaz MF, Ekici A. Retrospective review of children with vertigo: a 3-year experience. Eur Res J 2020;6(5).449-56.
  • 2. Niemensivu R, Kentala E, Wiener-Vacher S, Pyykkö I. Evaluation of vertiginous children. Eur Arch Otorhinolaryngol 2007; 264:1129-35.
  • 3. Davitt M, Devecchino MT, Aronoff SC. The differential diagnosis of vertigo in children. Pediatr Emerg Care 2020; 36(8):368-71.
  • 4. Erdoğan E, Güzel Nur B, Olgaç Dündar N. Vertigo in childhood: evaluation of clinical and laboratory findings. Türkiye Klinikleri J Med Sci 2012;36(6):1601-6.
  • 5. Raucci U, Vanacore N, Paolino MC, Silenzi R, Mariani R, Urbano A, et al. Vertigo/dizziness in pediatric emergency department: Five years’ experience. Cephalgia 2016;36:593-98.
  • 6. Batu ED, Anlar B, Topçu M, Turanlı G. Vertigo in childhood: A retrospective series of 100 children. Eur J Pediatr Neurol 2015; 19(2):226-32.
  • 7. Balatsouras DG, Kaberos A, Assimakopoulos D, Katotomichelakis M, Economou NC, Korres S. Etiology of vertigo in children. Int J Pediatr Otorhinolaryngol 2007;71:487-94.
  • 8. Kırık S, Özgör B, Özkars MY. Evaluation of pediatric patients presenting with vertigo. J Health Sci Med 2021; 4(3): 247-51.
  • 9. Staab PJ. Chronic dizziness. The interference between psychiatry and neuro-otology. Turkiye Klinikleri J Neur 2008;3:8-58.
  • 10. Emiroğlu FN, Kurul S, Akay A, Miral S, Dirik E. Assessment of child neurology outptients with headache, dizziness, and fainting. J Child Neurol 2004;19:332-6.
  • 11. Reale L, Guarnera M, Grillo C, Maiolino L, Ruta L,Mazzone L. Psychological assessment in children and adolescents with benign paroxysmal vertigo. Brain Dev 2011;33:125-30.
  • 12. Wiener-Vacher SR. Vestibular disorders in children. Int J Audiol 2008;47.578-83.
  • 13. Yang WC, Zhao LL, Chen CY, Wu YK, Chang YJ, Wu HP. First-attack pediatric hypertensive crisis presenting to the pediatric emergency department. BMC Pediatr 2012; 31:12-200.
  • 14. Serin HM, Arslan EA. Neurological symptoms of vitamin B12 deficiency: analysis of pediatric patients. Acta Clin Croat 2019; 58:295-302.
  • 15. Headache Classification Committee of the International Headache Society (IHS). The international classification of Headache disorders, 3rd edition (beta version). Cephalalgia 2013; 33: 629-808.
  • 16. Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth. Laryngoscope 2002; 112: 147-51.
  • 17. Gruber M, Cohen-Kerem R, Kaminer M, Shupak A. Vertigo in children and adolescents: Characteristics and outcome. Sci World J 2012; Article ID109624, 6 pages.
  • 18. Nimensivu R, Pyykkö I, Valanne L, Kentala E. Value of imaging studies in vertiginous children. 2006;70:1639-44.
  • 19. Klaus J. Vertigo and balance in children- Diagnostic approach and insights from imaging. Eur J Pediatr Neurol 2011;15:289- 94.

VERTIGO IN CHILDHOOD: HOW TO EVALUATE VERTIGINOUS CHILDREN?

Year 2021, Volume: 28 Issue: 4, 627 - 634, 30.12.2021
https://doi.org/10.17343/sdutfd.998278

Abstract

Objective
Vertigo is a complaint consisting of wide spectrum
of diagnoses in childhood. The aim of this study was
to evaluate clinical characteristics and differential
diagnosis of pediatric patients with vertigo.
Material and Methods
In this retrospective study, the medical records of
a hundred patients who presented to the Pediatric
Neurology Outpatient clinic with the complaint of
vertigo between January 2018-January 2021 were
reviewed. Patients were evaluated for age, gender,
family history, duration of symptoms, frequency of
attacks, provoking factors, accompanying symptoms,
physical examination, laboratory findings and final
diagnosis.
Results
The mean age was 12.39 years. The majority of the
patients were males (64%). There were different
causes of vertigo, but the most common two were
infection (34%) and psychogenic vertigo (25%). The
other frequent reasons were orthostatic hypotension
(16%) and vitamin B12 deficiency (9%). Most of the
patients had symptom duration for less than one
month (46%), and the attacks were primarily seen
(65%) every day. Patients explained their attacks as
the motion of the surrounding (61%), spinning (27%),
imbalance (20%), and others. The most common
accompanying symptoms were fatigue (60%) and
headache (54%). Laboratory data revealed vitamin
B12 deficiency in nine patients; all other tests were
in the normal range. Thirty-nine patients had cranial
MRI, only 2 of them revealed abnormal findings, one
of them was responsible for vertigo.
Conclusion
Vertigo in children creates a profound sense of
anxiety both in parents and physicians leading to
excessive number of functional testing and imaging
examinations. Evaluation should begin with detailed
history and comprehensive physical evaluation to
avoid superfluous testing and diagnostics. Serious
cases are fortunately rare and can be detected by
careful clinical examination.

References

  • 1. Korkmaz MF, Ekici A. Retrospective review of children with vertigo: a 3-year experience. Eur Res J 2020;6(5).449-56.
  • 2. Niemensivu R, Kentala E, Wiener-Vacher S, Pyykkö I. Evaluation of vertiginous children. Eur Arch Otorhinolaryngol 2007; 264:1129-35.
  • 3. Davitt M, Devecchino MT, Aronoff SC. The differential diagnosis of vertigo in children. Pediatr Emerg Care 2020; 36(8):368-71.
  • 4. Erdoğan E, Güzel Nur B, Olgaç Dündar N. Vertigo in childhood: evaluation of clinical and laboratory findings. Türkiye Klinikleri J Med Sci 2012;36(6):1601-6.
  • 5. Raucci U, Vanacore N, Paolino MC, Silenzi R, Mariani R, Urbano A, et al. Vertigo/dizziness in pediatric emergency department: Five years’ experience. Cephalgia 2016;36:593-98.
  • 6. Batu ED, Anlar B, Topçu M, Turanlı G. Vertigo in childhood: A retrospective series of 100 children. Eur J Pediatr Neurol 2015; 19(2):226-32.
  • 7. Balatsouras DG, Kaberos A, Assimakopoulos D, Katotomichelakis M, Economou NC, Korres S. Etiology of vertigo in children. Int J Pediatr Otorhinolaryngol 2007;71:487-94.
  • 8. Kırık S, Özgör B, Özkars MY. Evaluation of pediatric patients presenting with vertigo. J Health Sci Med 2021; 4(3): 247-51.
  • 9. Staab PJ. Chronic dizziness. The interference between psychiatry and neuro-otology. Turkiye Klinikleri J Neur 2008;3:8-58.
  • 10. Emiroğlu FN, Kurul S, Akay A, Miral S, Dirik E. Assessment of child neurology outptients with headache, dizziness, and fainting. J Child Neurol 2004;19:332-6.
  • 11. Reale L, Guarnera M, Grillo C, Maiolino L, Ruta L,Mazzone L. Psychological assessment in children and adolescents with benign paroxysmal vertigo. Brain Dev 2011;33:125-30.
  • 12. Wiener-Vacher SR. Vestibular disorders in children. Int J Audiol 2008;47.578-83.
  • 13. Yang WC, Zhao LL, Chen CY, Wu YK, Chang YJ, Wu HP. First-attack pediatric hypertensive crisis presenting to the pediatric emergency department. BMC Pediatr 2012; 31:12-200.
  • 14. Serin HM, Arslan EA. Neurological symptoms of vitamin B12 deficiency: analysis of pediatric patients. Acta Clin Croat 2019; 58:295-302.
  • 15. Headache Classification Committee of the International Headache Society (IHS). The international classification of Headache disorders, 3rd edition (beta version). Cephalalgia 2013; 33: 629-808.
  • 16. Bachor E, Wright CG, Karmody CS. The incidence and distribution of cupular deposits in the pediatric vestibular labyrinth. Laryngoscope 2002; 112: 147-51.
  • 17. Gruber M, Cohen-Kerem R, Kaminer M, Shupak A. Vertigo in children and adolescents: Characteristics and outcome. Sci World J 2012; Article ID109624, 6 pages.
  • 18. Nimensivu R, Pyykkö I, Valanne L, Kentala E. Value of imaging studies in vertiginous children. 2006;70:1639-44.
  • 19. Klaus J. Vertigo and balance in children- Diagnostic approach and insights from imaging. Eur J Pediatr Neurol 2011;15:289- 94.
There are 19 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Müjgan Arslan 0000-0002-0486-3431

Publication Date December 30, 2021
Submission Date September 21, 2021
Acceptance Date October 14, 2021
Published in Issue Year 2021 Volume: 28 Issue: 4

Cite

Vancouver Arslan M. VERTIGO IN CHILDHOOD: HOW TO EVALUATE VERTIGINOUS CHILDREN?. Med J SDU. 2021;28(4):627-34.

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