Vestibular assessment in the pediatric population

Dhondt, Cleo; Dhooge, Ingeborg; Maes, Leen

doi:10.1002/lary.27255

Cited by 29 publications

(51 citation statements)

References 14 publications

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“…During each acquisition, special attention was paid to ensure that the bone conductor was always correctly kept in the above described position. At the same time, the parent provided distraction at the contralateral side with some toys or a movie 23,33 . In this way, the child was motivated to maintain sufficient and stable SCM muscle contraction.…”

Section: Vestibular Screening Protocolmentioning

confidence: 99%

“…Recently, there is an increasing interest among clinicians in the vestibular function of hearing-impaired children and several researchers have proven the feasibility of vestibular testing from an early age on by adapting the standard test protocol to children [22][23][24][25] . However, paediatric vestibular dysfunction often goes unnoticed due to the atypical expression of vestibular symptoms and the limited communicative abilities of young children 18,26 .…”

mentioning

confidence: 99%

“…This Flemish research project includes a standard vestibular screening by means of the cervical Vestibular Evoked Myogenic Potentials (cVEMP) test at the age of 6 months 33 . Although the vestibular screening by means of the cVEMP mainly evaluates saccular function and does not evaluate all vestibular end organs, the cVEMP is chosen as screening tool because this is a short, objective and child-friendly test 2,23,34,35 . Several studies have also demonstrated a higher percentage of otolith dysfunction compared to semicircular canal dysfunction in hearing-impaired children due to the closer anatomical and embryological relationship between the otolith organs and the cochlea [36][37][38] .…”

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confidence: 99%

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Vestibular Infant Screening (VIS)–Flanders: results after 1.5 years of vestibular screening in hearing-impaired children

Martens

Dhooge

Dhondt

et al. 2020

Sci Rep

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Due to the close anatomical relationship between the auditory and vestibular end organs, hearing-impaired children have a higher risk for vestibular dysfunction, which can affect their (motor) development. Unfortunately, vestibular dysfunction often goes unnoticed, as vestibular assessment in these children is not standard of care nowadays. To timely detect vestibular dysfunction, the Vestibular Infant Screening–Flanders (VIS–Flanders) project has implemented a basic vestibular screening test for hearing-impaired infants in Flanders (Belgium) with a participation rate of 86.7% during the first year and a half. The cervical Vestibular Evoked Myogenic Potentials (cVEMP) test was applied as vestibular screening tool to map the occurrence of vestibular (mainly saccular) dysfunction in this population. At the age of 6 months, 184 infants were screened. No refers on vestibular screening were observed in infants with permanent conductive hearing loss. In infants with permanent sensorineural hearing loss, a cVEMP refer rate of 9.5% was observed. Failure was significantly more common in infants with severe-profound compared to those with mild-moderate sensorineural hearing loss (risk ratio = 9.8). Since this is the first regional study with a large sample size and successful participation rate, the VIS–Flanders project aims to set an example for other regions worldwide.

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Section: Vestibular Screening Protocolmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Vestibular Infant Screening (VIS)–Flanders: results after 1.5 years of vestibular screening in hearing-impaired children

Martens

Dhooge

Dhondt

et al. 2020

Sci Rep

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“…Video Head Impulse Testing (version III, Synapsys Ulmer, Marseille, France) leads to several response parameters, of which we compared the VOR gain, asymmetry and ratio of corrective saccades to our center-specific normative values. Details about the test setup are outlined in Dhondt et al (12).…”

Section: (Video) Head Impulse Test -(V)hitmentioning

confidence: 99%

Episodic Vestibular Symptoms in Children With a Congenital Cytomegalovirus Infection: A Case Series

Dhondt¹,

Maes

Oostra

et al. 2019

Otology &Amp; Neurotology

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Objective: Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss in children. Although cCMV-induced vestibular loss is demonstrated in several studies, the occurrence of vertigo has been described in only two cases to date. The aim of this paper is to discuss the underlying pathophysiology of recurrent vestibular symptoms in children with cCMV, based on five cases investigated in our center and an extensive research of the literature. Study Design: Retrospective case series. Setting: Tertiary referral center. Patients: This case series describes five pediatric cCMV-patients (three boys, two girls). Four of them were symptomatic at birth, one was asymptomatic. Three patients underwent cochlear implantation. The age of onset of the vestibular symptoms varied from 2;0 to 7;3 years of age. Intervention: None Main Outcome Measures: Details about the patient history and results of cranial imaging, audiological, vestibular and neurological assessments were collected retrospectively. Results: The selected cases suffered from recurrent vestibular symptoms. All patients had delayed onset, fluctuating and/or progressive hearing loss. In all cases, the attacks were accompanied with nausea and vomiting and occurred without clear-cut trigger. Migraine and epilepsy often were proposed as first diagnosis, although they could not be confirmed eventually. Four out of five patients were diagnosed with a peripheral vestibular deficit. 4 Conclusions: Diagnosis of vestibular symptoms in children with cCMV is complex, given the multiple morbidities than can occur. Peripheral vestibular causes should be considered in the diagnosis, as important vestibular deficits are demonstrated in this population.

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“…1 No entanto, este valor pode subestimar a verdadeira prevalência desta entidade, tendo em conta que a DV na criança tem uma expressão distinta da dos adultos. 2 Os sinais e sintomas de DV em pediatria podem variar desde alterações visuais, cefaleias, descoordenação na marcha, atraso motor, dificuldade na aprendizagem, vertigem rotatória, podendo, em alguns casos, não ter qualquer manifestação clínica. Por outro lado, a relação anatómica estreita entre a cóclea e as estruturas vestibulares pode, segundo alguns autores, explicar o porquê de muitas crianças com hipoacusia sensorioneural terem algum grau de DV.…”

Section: Introductionunclassified

Patologia Vestibular em Idade Pediátrica: Análise Retrospetiva e Revisão da Literatura

et al. 2021

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Introduction: Vestibular disorders in pediatric patients is still a controversial subject but has gained relevance over the years. In recent studies, its prevalence varied between 0.7% and 15%. Nevertheless, the true prevalence can be underestimated given that its clinical presentation is expressed compared to adults; it can present as rotatory vertigo, but It can also cause vision complaints, headaches, motor delay, and learning disability. Although middle ear effusion is considered the main cause of vestibular dysfunction in this age group, other diagnoses should be considered. The aim of this study was to describe clinical features of the pediatric population referred to a subspecialist Otorhinolaryngology vertigo clinic in a tertiary hospital between 2013 and 2017. We also aimed to compare the results and carry out a literature about the most common causes, diagnostic features and treatment approach.Material and Methods: Clinical records of patients referred to a subspecialist Otorhinolaryngology vertigo clinic with suspicion of vestibular dysfunction aged between 0 and 18 years old were reviewed. Patients with middle ear effusion were excluded.Results: Thirty-seven patients met the inclusion criteria. From these, 59% were female, with a mean age of 10.9 years old during the first consultation. The most common reason for referral was rotatory vertigo. Nausea and headache were also frequent complaints in our population. All patients performed audiometry; videonistagmography was performed in 41% of the cases; imaging studies were done in 59% of patients. The most common causes of vestibular dysfunction were vestibular migraine and benign paroxysmal vertigo of childhood (both in 27% of the cases), followed by vestibular neuritis (in 22% of the cases).Discussion: Although our findings partially concur with the literature, compared with other specialist centers, the range of reasons for referral and of conditions is not as diverse, which may suggest that there is underdiagnosis of vestibular dysfunction in this age group.Conclusion: Vestibular dysfunction in the pediatric age can have several causes; pediatricians, neurologists, physiatrists, family doctors and otorhinolaryngologists must be aware of the different forms of presentation. Referral and evaluation protocols addressing pediatric patients should be created.

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Vestibular assessment in the pediatric population

Cited by 29 publications

References 14 publications

Vestibular Infant Screening (VIS)–Flanders: results after 1.5 years of vestibular screening in hearing-impaired children

Vestibular Infant Screening (VIS)–Flanders: results after 1.5 years of vestibular screening in hearing-impaired children

Episodic Vestibular Symptoms in Children With a Congenital Cytomegalovirus Infection: A Case Series

Patologia Vestibular em Idade Pediátrica: Análise Retrospetiva e Revisão da Literatura

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