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Symptoms of vertigo in a child, hearing damage sound levels - For Begninners

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Department of Neurology, Children´s Memorial Health Institute, Warsaw, PolandHead: prof.
SummaryThe purpose of the study was to review clinical presentation, diagnostic methods, and conditions causing vertigo and dizziness in children. Vertigo and dizziness as major complaints in childhood are probably present more often than formerly thought (6, 7). Vertigo is a disorder of space sensitivity, characterized by an illusory and unpleasant sensation of movement of the surroundings or self (5).
Vertigo and dizziness may take on very different shapes and aspects, so that it is often difficult to identify its etiopathogenesis.
The purpose of the study was to review the clinical pesentation, diagnostic methods and conditions causing vertigo and dizziness in children. In this paper we have analyzed two groups of patients referred to specialists (usually by paediatric doctors) with a diagnosis of vertigo or dizziness. B – At the same time (1995-2000) another 49 children (aged 2-14 yrs) suffering from vertigo were treated at the Outpatient Clinic in the Department of Paediatric Neurology. Evaluation of a dizzy child entails close co-operation between the otolaryngologist, paediatrician, neurologist and ophtalmologist (3, 5). Twenty-one patients, (11 females and 10 males), complaining mainly of vertigo or dizziness were studied retrospectively. Six children, before the onset of vertigo or dizziness, had head trauma, and 4 had suffered from a mumps infection.

In 1 child we diagnosed a unilateral peripheral weakness of vestibular function after infection of the alimentary tract, and 1 child had a unilateral weakness of unknown aetiology. In summary, vertigo or dizziness in our patients was caused by: head trauma in 7 cases, partial epilepsy in 5 cases, migraine in 3 children, otitis in 3 children, BPV in 3 and childhood infection in 3 cases. 4.In our material the aetiology of vertigo and dizziness was often connected with other diseases of the central nervous system. If vertigo is caused by an inner ear problem, the health care provider may prescribe medications.
Keep your child from activities that require balance or coordination until vertigo is gone. The authors report a retrospective review of 70 children diagnosed in the ENT Department or Outpatient Clinic in the Department of Paediatric Neurology. However, the very young child cannot make such a report, and information therefore comes from the parents´ observation of their child´s behaviour. A careful anamnesis always has an essential role in the diagnosis of vertigo, together with evaluation of clinical signs and diagnostic tests (3-6). Important facts can be obtained not only from parents but (more frequently than expected) from the child. Its diagnosis is based on the exclusion of all other forms and on the fact that attacks are repeated in the absence of any evident association with other symptoms (3, 10). The differential diagnosis of dizziness and vertigo in children requires a multidisciplinary approach.

Along with vertigo or dizziness, 9 children had associated headaches, 11 had nausea and vomiting, and 3 patients had only nausea. Two patients were considered to have vertigo and unilateral sensorineural hearing loss due to mumps infection.
In the remaining patients vertigo problems had a different aetiology, representing each by 1 case. From an analysis of the results, a diagnostic approach to the dizzy child is suggested, and the most frequent conditions causing vertigo in children are discussed. Nystagmus was found in all patients suffering from Benign Paraxysmal vertigo, sometimes in Epileptic children, and after head trauma.
The most common symptom of dysfunction of the vestibular organ was unilateral asymmetry of the vestibular activity. A general physical examination should cover cardiovascular and respiratory symptoms, because associated symptoms may be misinterpreted as dizziness. Investigations should be selected in a logical manner, the clinician´s own judgement determining which child requires full vestibular assessment, CT scan, or EEG, to make or exclude a particular diagnosis (3).

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