Considerations for Testing and Treating Children with Central Vestibular Impairments

Abstract

This perspective explores common pediatric diagnoses that could present with central vestibular pathway dysfunction, leading to delays in motor development and postural control, and gaze instability. Specifically, the following diagnoses are considered: cerebral palsy, myelomeningocele, vestibular migraine, attention-deficit hyperactivity disorder, developmental coordination disorder, concussion, childhood cancer, congenital muscular torticollis, adolescent idiopathic scoliosis, and autism. Suggestions for clinical screening, vestibular function testing, and vestibular rehabilitation for children with these diagnoses are based on evidence for the efficacy of testing and interventions for children with peripheral vestibular hypofunction. More research is needed to explore peripheral and central vestibular function in children with these diagnoses. Testing and intervention methods may need to be modified to accommodate for the specific behavior and motor challenges that some children might present. Researchers should develop technology so that gaze stabilization exercises can be delivered in a fun, functional, and effective way.

Rehabilitación vestibular en la infancia

“…Determinar la maduración de los reflejos óculo-vestibulares y del desarrollo postural y motor en niños en función de la edad. Christy [10] 2018 Artículo de revisión. Explorar posibles patologías infantiles que presenten alteraciones en las vías vestibulares centrales que condicionen retrasos en el desarrollo motor, control postural e inestabilidad en la mirada.…”

“…Si el daño periférico es bilateral y simétrico (hipofunción vestibular asociada a HNS congénita, ototoxicidad...), aparecerán alteraciones relacionadas con el desarrollo motor y síntomas posturales. Los pacientes con lesiones centrales, aunque pueden experimentar crisis de vértigo episódico como en la migraña, lo habitual es que se presenten con síntomas crónicos de mareo y manifestaciones en el ámbito del desarrollo motor [10]. Los síntomas visio-vestibulares como la oscilopsia, aunque son más típicos de Pérez-González R, Gancedo-Fernández S, Rodríguez-García A et al…”

Normative values for the video Head Impulse Test in children without otoneurologic symptoms and their evolution across childhood by gender

“…Vertigo is a more common complaint among adults than in the pediatric population [ 1 ]. However, the incidence of vestibular disorders during childhood is rising, probably due to greater awareness of their existence and the improvements in otoneurological and vestibular diagnosis [ 2 – 5 ]. Indeed, various reports describe children with vestibular dysfunction [ 6 – 10 ], including those presenting as complications after cochlear implantation [ 11 ], Meniere’s disease [ 12 ], otitis media with effusion [ 13 ], cytomegalovirus infection [ 14 ], primary ciliary dyskinesia [ 15 ], sensorineural hearing loss [ 16 ], and migraine [ 8 , 17 ].…”