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ENT
Dizziness in the Pediatric Patient
Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
What’s inside
9 sections · 97 slides
Overview
- Scope of this topic
- Structure of the assessment
Assessment of the dizzy child
- Why paediatric vestibular disease is missed
- History elements shared with adults
- History elements specific to children
- Developmental reflexes in vestibular evaluation
- Eliciting nystagmus in the pre-verbal child
- Bedside tests transferable from adults
- Membranous labyrinth of the inner ear
Vestibular screening in sensorineural hearing loss
- Vestibular impairment in congenital hearing loss
- Why implantation renewed the question
- Three-step vestibular screening protocol
- Gross motor milestones as a vestibular screen
- Normal ranges for the development of motor milestones
- Balance skill testing with the BOT2
- Expected one foot standing times according to age [ 9 ]
Vestibular testing in children
- Why testing is under-used in children
- Principles of a paediatric test battery
- Keeping the child engaged
- Age considerations for vestibular testing in children
- Videonystagmography in children
- Caloric testing: air versus water irrigation
- Tips for caloric testing in children
- Rotary chair testing in children
- Modifications for rotary chair testing
- Interpreting rotary chair data in children
- Video head impulse test in children
- Goggle systems approved for use in children
- Tips for video head impulse testing in children
- Cervical and ocular VEMP in children
- Tips for VEMP testing in children
- Bone conduction VEMP with middle ear effusion
- Computerized dynamic posturography in children
- Maturation of the three balance inputs
Vestibular disorders in children
- Which disorders behave as in adults
- Migraine as the leading cause of paediatric vertigo
- Migraine variants presenting with vertigo
- Benign paroxysmal torticollis of infancy
- Reclassification of BPTI as a migraine variant
- Precipitants and associations of BPTI
- Vestibular test results in BPTI
- Diagnostic criteria of BPTI , adapted from ICHD, 3rd edition [ 30 ]
- Recurrent vertigo of childhood
- Diagnostic criteria of RVC [ 30 ]
- Vestibular migraine of childhood
- Acute treatment of migraine variants in children
- Prophylaxis and non-pharmacological measures
- Benign paroxysmal positional vertigo in children
- Differences from adult BPPV
Central conditions associated with ataxia
- Genetic ataxias as vestibular mimickers
- Examination that exposes the mimickers
- Friedreich ataxia
- Ataxia-telangiectasia
- Spinocerebellar ataxias
- Episodic ataxias as peripheral mimickers
- Episodic ataxia type 2
- Episodic ataxia type 1
- Attack duration across the episodic conditions
Conditions associated with hearing loss
- CHARGE syndrome
- Iris coloboma
- Vestibular compensation in CHARGE syndrome
- Usher syndrome types
- Retinal appearance in retinitis pigmentosa
- Vestibular screening as a route to diagnosis
- Enlarged vestibular aqueduct syndrome
- Proposed mechanism of vestibular damage in EVA
- Middle ear effusion and balance
- Otoscopic appearance of middle ear effusion
- Conducting mechanism and the labyrinth
Structural central nervous system lesions
- Central lesions presenting with dizziness
- Suspicion of neoplasm in the dizzy child
- Chiari malformation
- Cerebellar tonsillar herniation on sagittal MRI
- Red flags prompting imaging
Summary
- Key points on assessment
- Key points on testing
- Key points on the differential
- Conclusion
- References
- References (continued)
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- References (continued)
- Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
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