Comprehensive vestibular and balance testing in the dizzy pediatric population.

OBJECTIVE: To describe the spectrum of balance disease in a large population of children presenting to a tertiary care vestibular and balance laboratory.

STUDY DESIGN: Case series with chart review.

SETTING: Tertiary care pediatric hospital.

MAIN OUTCOME MEASURES: Results of audiometric, vestibular, and balance tests and final diagnosis.

SUBJECTS AND METHODS: Retrospective review of audiometric, vestibular, balance testing, and final diagnosis from a patient database.

RESULTS: Between September 2003 and September 2007, 132 children were evaluated at the Alfred I. duPont Hospital for Children Vestibular Disorders Program. Sixty-nine of the patients were boys and 63 were girls. The average age was 9.7 ± 5.0 years (range, 1-17 years). Although not all were able to complete the entire test battery (99 children completed at least 50% of the tests in the protocol), a diagnosis was achieved in most cases. The most common diagnoses were peripheral vestibulopathy (29.5%), migraine/benign recurrent vertigo of childhood (24.2%), motor/developmental delay (10.6%), traumatic brain injury (9.8%), and central nervous system structural lesion (9.1%).

CONCLUSIONS: Peripheral vestibular deficits and migraine disease account for most of the pathology in the pediatric population. With a multidisciplinary approach, diagnosis of the source of vertigo and imbalance is possible in most children.