Vestibular disorders affect children

As there is no real litmus test for Meniere's disease, children with hearing loss, tinnitus and vertigo without other diagnoses may present from time to time.

Vertigo in children is less frequent than in adults. However, besides equilibrium disorders caused by hereditary malabsorption syndromes or lesions in the peripheral and central vestibular structures, there are typical diseases that are associated with vertigo and hearing problems and develop during childhood. In children, one can also see vertigo in the form of attacks that may be accompanied by hearing problems. Examiners must rely on parents' or relatives' observations and reports when it comes to an affected child's history, as such children cannot provide detailed descriptions of their symptoms.

During neurootological examinations and while evaluating test results, examiners must consider a child’s age, development, and cooperation throughout the tests. Several neurootological tests can be used: vestibular tests, vestibuloocular reaction, oculomotor tests, vestibulospinal tests, visuovestibular interaction analysis, and visuoproprioceptive interaction analysis.

Various causes can trigger vertigo. They include different types of nystagmus, disturbances of the labyrinth and central vestibular structures; lesions in the visual and vestibulospinal systems caused by heredity or by toxic agents; and brain tumors, meningitis, encephalitis, otitis, fistulas of the labyrinth or head trauma, and the like.

In the Ear, Nose and Throat Clinic of Brno, a total of 400 patients were listed with diagnosed Meniere's disease. These patients' ages ranged between 7 and 79 years (190 males [47.5%] and 210 females [52.5%]). The maximum appearance of Meniere's disease occurred during the fifth and sixth decades of life.

However, of this group of patients, eleven (2 .75%) were children aged between 7 and 15 years: three 7-year-olds, three 9-yearolds, and five 15-year-olds. All 11 children showed the typical history of rotatory-type vertigo attacks lasting a few hours, with fluctuating hearing disorders and tinnitus. The older children also reported feelings of fullness in the affected ear. Additional symptoms during the attacks were nausea and vomiting.

The audiological findings showed fluctuating hearing loss on one side. In cases in which children were able to explain, researchers discovered that tinnitus was most apparent in the lower frequencies. The electronystagmography showed mainly dysrhythmical nystagmus patterns, with the tendency to hyperreflexia on the affected side. Spontaneous eye movements were not systematically directed to one side. The complex diagnostic workup, including neurology, ophthalmology, internal medicine, and computed tomography, showed no pathological findings.

Treatment in children with Meniere's disease should include a dietary plan , supplementing with the vitamin B complex, sedatives and tranquilizers (depending on an affected child's complaints), and vasoactive drugs. The authors also recommend looking at the consequences of the disease for further development of an affected child (to take into consideration the selection of the child's future occupation).

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