The aim of this study was to assess the prevalence and analyze clinical parameters of benign positional paroxysmal vertigo (BPPV) in a pediatric age. A cohort of 423 children under the age of 15 (median age 11. interquartile range 9–13) was submitted to vestibular assessment for balance disorders. Dix-Hallpike and Roll-Supine tests were performed to look for positioning nystagmus using video-infrared goggles. BPPV was found in 43 of 423 children evaluated for balance disorders (10.2%). There were 28 females (65.1%) and 15 (34.9%) males. The posterior canal was involved in 79% of cases and the horizontal canal in 21% of cases. No apogeotropic bilateral or anterior canal form were seen. Thus, BPPV is not an infrequent type of vertigo in children and must be evaluated as soon as possible in order to plan the most appropriate maneuver and restore daily activities as soon as possible, avoiding anxiety and fear.

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases.

Objective The current chapter will focus on epidemiological, etiological, and clinical data to optimize diagnostic and therapeutic approach of balance disorders in childhood. Methods Personal experience and analysis of the literature. Results The vestibular system is one of the first functioning systems of the human body. The vestibulo ocular reflex (VOR) is present at birth, and its values approaches those of a normal adult by 2 months of age. The vestibulospinal and vestibulocollic mechanism and the effectiveness of the vestibular system in postural control develop along a more protracted time course. Postural stability is mainly controlled by visual inputs in infants and children, whereas somatosensory inputs are primary in adults. Children begin to properly use somatosensory information at 3-6 years of age. Competence of the sensory systems to manage intersensory conflict is reached around 15 years of age. Conclusion Balance disorders, at any stage of a children neurodevelopment, can be very debilitating, worsening their basic daily activities and they can lead to psycho-neurological, affective, and behavioral dysfunctions.