Trastornos del equilibrio en la infancia Principales etiologías según la edad. Utilidad de la prueba de impulso de la cabeza de video

Balance disorders in childhood Main etiologies according to age. Usefulness of the video head impulse test

Patricia Alejandra Sommerfleck (a, *), María Emilia Gonz
alez Macchi (a), Romina Weinschelbaum (b), Maximiliano Damian De Bagge (a), Patricia Bernàldez (a), Sergio Carmona (b)

(a) Otorhinolaryngology Department, Hospital de Pediatría “Prof. Dr. Juan P. Garrahan”, Argentina

(b) Neuro-otology Department, INEBA Instituto de Neurociencias de Buenos Aires, Argentina

Abstract

Balance disorders are common in adult patients but less usual in the pediatric population. When this symptomatology appears in children it is a cause for concern, both for parents and health-care professionals.

Objectives: To explain the balance disorders in children describing a case series and to discuss the main etiologies found according to age.

Study design: A retrospective, observational, descriptive, and cross-sectional study was conducted.

Population: Patients aged 1e18 years who consulted because of balance disorders at the otolaryngology department of a pediatric tertiary-care hospital between March 2012 and July 2015.

Results: Two hundred and six patients were included in the study. Median age was 10 years. The most common diagnoses were vestibular migraine in 21.8% of the children, ataxia in 9.22%, benign paroxysmal vertigo of childhood in 7.77%, and post-traumatic vertigo in 6.31%. Overall, 61 videonystagmographiese of which 46 were normal - and 55 video head impulse tests - which were normal in 45 and showed abnormalities in the vestibulo-ocular reflex gain in 10 - were performed.

Conclusions: In a child with balance disorders, the medical history and neurotological examination are essential. Vestibular migraine is the most commonly found disorder in every age group, and most of the patients have a family history of migraine. Ancillary studies, especially the video head-impulse test, provide important data to confirm the diagnosis.