What is the Pediatric Vertigo?

Pediatric Vertigo is characterized by a spinning sensation, dizziness, nausea, vomiting, motion sickness, & disorientation. Some people can also experience migraine headaches & general weakness along with dizziness and other vertigo-like symptoms. Nystagmus, an abnormal jerking movement of the eyes back & forth or upwards & downwards, is also sometimes associated with vertigo & dizziness.

Vertigo & dizziness in children can also occur during active infection of illness like the cold or the flu, which causes congestion in the chest & compression of the vestibular nerves. The vestibular system, which controls & maintains the body’s balance, is located inside the inner ear. When infection or illness causes swelling or inflammation inside the inner ear, it can lead to dizziness, vertigo-like symptoms, nausea, motion sickness, & other assorted symptoms.

However, infection or illness-induced dizziness usually lasts only until the time the infection is treated. Once the infection resolves, this dizziness should go away. If dizziness & other vertigo-like symptoms persist in a child or occur for prolonged periods of time without any noticeable signs of infections or other illnesses, it likely is an issue with the vestibular system, or in few cases, with the central nervous system.

Vertigo is far more common in adults than in children. For this reason, very few kids suffer from childhood Benign Paroxysmal Positional Vertigo, dizziness, & other types of vertigo. Vertigo & dizziness can be very difficult for a child to handle, as they haven’t yet gotten a hang of their bodies completely.

For this reason, Pediatric Vertigo & dizziness & BPPV of childhood often need immediate medical attention to help relieve the child’s condition and allow them a healthy, fulfilled life.

Causes of pediatric dizziness & vertigo:

Vertigo & dizziness in children can occur with or without an ear problem. An inner ear disorder causes problems with the way the vestibular system sends balance-related signals to the brain, causing misfires and sensations of movement even when there is none.

Most of these inner ear problems are associated with minor illnesses or ailments that resolve quickly with adequate treatment. In these cases, vertigo caused by these issues also resolves with the resolution of the underlying problem.

However, some other conditions can also cause vertigo & dizziness in children. If this is the case, you may find that your child’s bouts of dizziness and vertigo are more persistent & severe. In such cases, you might also find that these bouts of dizziness & vertigo attacks are triggered by certain head movements and changes in the position of the head. Along with dizziness, your child may also experience nystagmus(abnormal eye movements), nausea, vomiting bouts, & motion sickness.

Some other possible causes of vertigo & dizziness in children include:

• Middle ear infection: Middle ear infection is the most common cause of vertigo & dizziness in children. Dizziness in children can also be caused by a middle ear ‘effusion’ in which a thick fluid builds up behind the eardrum, causing problems with the way the vestibular system works & sends balance-related signals to the brain.
• Inner ear infections: Inner ear infections like labyrinthitis & Vestibular Neuritis can also cause dizziness & vertigo in children.
• Concussion & any other kind of head trauma or head injuries can also cause dizziness and vertigo in children.
• Tiny bone-like particles floating in the inner ear fluid. These can be either due to an infection or a concussion due to an injury.
• Migraine headaches can also cause dizziness & vertigo in children. Children prone to migraine headaches are also more likely to get vestibular migraines later on in life.
• BPPV, Benign Paroxysmal Positional Vertigo, is also another common cause of dizziness & vertigo in children. BPPV refers to sudden dizziness & spinning sensations that make a person feel like their surroundings are spinning or moving out of control, along with nausea, vomiting, headaches, & nystagmus. Benign Paroxysmal Positional Vertigo of childhood is also a potential cause of migraines in adulthood.
• Seizures
• Low Blood Pressure
• Certain autoimmune disorders like Multiple Sclerosis, Type 1 Diabetes, & juvenile arthritis.
• Visual dysfunctions like an excessive difference in prescription between the eyes and a congenital eye movement disorder.
• A brain tumour
• Meniere’s Disease
• Aspirin & other non-steroidal anti-inflammatory drugs

Pediatric Vertigo symptoms:

Vertigo symptoms differ from one child to another, & not every child experiences similar symptoms. These symptoms often depend on the severity & the type of vertigo that your child experiences.

Some common symptoms include:

• Dizziness, along with a perception of the surroundings spinning around or moving. Your child may also experience a ‘head tilting’ sensation, or feel like they are on a ‘rocking’ boat. They might also experience motion sickness.
• Dizziness is triggered by changes in your child’s head position, like turning their head or standing up from a lying down position. This kind of dizziness & vertigo usually lasts for only a few minutes.
• Any unusual awkwardness, clumisiness, or inability to maintain balance
• tinnitus(a ringing sound in the eard), stuffiness inside the ear, & feelings of pressure, ear pain
• Hearing loss in one or both ears
• Fever of more than 100 degrees
• Migraine
• Confusion
• Fainting or collapsing
• Nausea
• Vomiting
• Sweating
• Pale complexion
• Nystagmus, a back & forth movement of the eyes
• Wanting to lie still & not move or participate in any activities
• Loss of movement or motor skills
• Slowness in lifting up head, holding their head upright, stand or walk

Testing and & Diagnosis:

Your doctor will likely refer your child to a pediatric ENT specialist as diagnosing vertigo can be difficult. They will check your child for signs of infection, including ear exams to look for ear infections & eardrum damage, etc. They will also ask for a detailed medical history of your child, including any recent injuries or illnesses they might have had, to rule out other possible causes of dizziness & vertigo-like symptoms. They will also conduct certain tests on your child to determine if they indeed suffer from BPPV of childhood or other dizziness disorders. These tests include:

• Audiometry, also known as hearing tests
• Thorough physical examination of the ears & the eyes
• Vestibular function tests, examples include rotational chairs
• Electronystagmography(ENG) tests, which include electrodes placed on your ears to record abnormal eye movements
• Electroencephalography, a test that measures the electrical activity in your brain
• Blood tests
• Imaging tests like the CT scan, X-ray, or MRI scans
• Vestibular-ocular tests involving games & gaze fixation exercises
• Dynamic Visual Acuity tests
• Coordination & gross motor skills exercises, such as hopping, skipping, & jumping with your eyes open

Dizziness treatment:

Dizziness treatment depends on the exact cause of your child’s vertigo. A trained vertigo specialist & otolaryngologist will be able to devise a specific dizziness treatment plan based on your child’s exact vertigo & dizziness causes. In most cases, your child’s dizziness treatment plan will consist of vertigo medicines, vertigo exercises, & some home remedies.

Vertigo medicines like the vertin tablet & hydrochloride tablets are used for dizziness treatment, along with motion sickness medicines, antihistamines, anti-nausea, & migraine medications. Other treatment options include Vertigo exercises like the Epley Maneuver, the Brandt-Daroff exercises, & the Semont-Foster maneuver.

These vertigo exercises are helpful in relieving the dizziness & the head movement triggers associated with BPPV of childhood. Vestibular Rehabilitation Therapy is also helpful in helping the body compensate for the losses in the natural vestibular system. It helps by employing other organ systems to make up for the dysfunction in the natural vestibular system, & by training the brain to rely less on the signals from the vestibular system, & more on the other organ systems involved in maintaining the balance of the body.