Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness

Lüscher, Michael; Theilgaard, Sune A.; Edholm, Bjarke

doi:10.1017/s0022215114000188

Cited by 30 publications

(27 citation statements)

References 16 publications

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“…Meniere-like syndrome is rare in children in our experience (1.1%) compared to 13.8% in adults. 15 Meniere's syndromes associated with vertigo, hypoacousia, and tinnitus with a clogged ear have only been observed in our center since the past 8 years. Perhaps it is an underestimated diagnosis because all the symptoms are not always found during the interview: tinnitus and mild hearing loss are rarely reported spontaneously by the child.…”

Section: Meniere-like Syndromementioning

confidence: 97%

“…Benign paroxysmal positional vertigo (BPPV; canalolithiasis and cupulolithiasis) is rare in children outside a traumatic context, whereas in adults it is the most frequent diagnosis in patients with no context of cranial trauma (53% of vertigo cases in adults). 15 The clinical picture of nonpositional benign paroxysmal vertigo of childhood (BPVC) is characteristic of young children 2 to 5 years of age but is occasionally reported in older children. However, its prevalence in the literature is variable, ranging from 6 to 20%, probably because of the lack of a strict clinical definition, and also because of their rapid and spontaneous resolution (thus not arriving in specialized clinics).…”

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confidence: 99%

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Epidemiology of Vestibular Impairments in a Pediatric Population

2018

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The purpose of this study was to report the prevalence of vestibular impairment (VI) in children ( = 2,528) referred for complete vestibular testing because of balance disorders (BD) or hearing loss (H). A VI was shown in 51.5% of the children tested (1,304/2,528). For BD (e.g., vertigo, dizziness, instability, delay in posturomotor development), VI was found in 36.5% ( = 379/1,037). The most frequent causes of BD with VI included inner ear malformation (13.5%), delay in posturomotor development (13.4%), hearing loss revealed with vertigo (3.9%), trauma (3.9%), vestibular neuritis (3.3%), meningitis (2.5%), Meniere-like syndrome (1.1%), BPPV posttrauma (1%), labyrinthitis (0.4%), and unknown etiology (19.6%). Normal responses to the complete battery of tests ( = 658, 63.5%) excluded a vestibular origin to BD, leading to other diagnoses: principally migraine (15.6%), ophthalmological disorders (15.1%), neurological disorders (including delay in posturomotor development; 14.4%), orthostatic hypotension, or somatoform dizziness (<1%). Of the children referred for hearing loss ( = 1,491), 68.5% were tested without cochlear implantation (CI; = 1,022). In this group, 54.5% presented with VI ( = 557). This was mostly found in cytomegalovirus infection, inner ear malformation, and genetic syndromes. Profound hearing loss candidates for cochlear implants had complete bilateral vestibular loss in 20% and delay in posturomotor development, and 80% had partial or normal vestibular function and normal posturomotor development. VI was found after CI in 50% on the side of the implant (partial in 41% and complete in 9%). VI is present in 36.5% of children referred to our center for BDs and 54.5% for hearing loss. Vestibular testing permits ruling out peripheral VI and hence seeking other causes for BDs such as migraine and ophthalmological disorders and also helps lower the risk of inducing bilateral complete vestibular loss in CI protocols.

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Section: Meniere-like Syndromementioning

confidence: 97%

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confidence: 99%

Epidemiology of Vestibular Impairments in a Pediatric Population

2018

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“…) and is the leading cause of dizziness (Lüscher et al. ). It has been shown that UPVD patients struggle to maintain consistent arm actions during trunk movement without visual information (Raptis et al.…”

Section: Introductionmentioning

confidence: 99%

Deficient recovery response and adaptive feedback potential in dynamic gait stability in unilateral peripheral vestibular disorder patients

et al. 2014

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Unilateral peripheral vestibular disorder (UPVD) causes deficient locomotor responses to novel environments due to a lack of accurate vestibular sensory information, increasing fall risk. This study aimed to examine recovery response (stability recovery actions) and adaptive feedback potential in dynamic stability of UPVD‐patients and healthy control subjects during perturbed walking. 17 UPVD‐patients (>6 months since onset) and 17 matched healthy control participants walked on a treadmill and were subjected to eight unexpected perturbations during the swing phase of the right leg. For each perturbation, the margin of stability (MS; state of body's centre of mass in relation to the base of support), was determined at touchdown of the perturbed leg and during the following six recovery steps. The first perturbation caused a reduced MS at touchdown for the perturbed leg compared to baseline, indicating an unstable position, with controls requiring five recovery steps to return to MS baseline and UPVD‐patients not returning to baseline level within the analyzed six recovery steps. By the eighth perturbation, control subjects needed two steps, and UPVD‐patients required three recovery steps, both thereby improving their recovery response with practice. However, MS at touchdown of the perturbed leg increased only for the controls after repeated perturbations, indicating adaptive feedback‐driven locomotor improvements for the controls, but not for the UPVD‐patients. We concluded that UPVD‐patients have a diminished ability to control dynamic gait stability during unexpected perturbations, increasing their fall risk, and that vestibular dysfunction may inhibit the neuromotor system adapting the reactive motor response to perturbations.

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“…4 The Epley particle repositioning manoeuvre has become the standard treatment for this condition. Hughes and colleagues investigated the number of Epley manoeuvres required for symptom control in BPPV.…”

Section: Focus On Epistaxismentioning

confidence: 99%