Vertigo in Children: Diagnostic Approach and Treatment

Diagnostic Considerations

• The American Academy of Otolaryngology-Head and Neck Surgery suggests that labyrinthitis/vestibular neuronitis represents 8.47% of cases and presents with acute prolonged vertigo without hearing loss (vestibular neuronitis) or with hearing loss (labyrinthitis) 2
• Benign paroxysmal positional vertigo (BPPV) occurs in children but is less common than in adults, characterized by brief episodes (<1 minute) triggered by head position changes 3
• The American Academy of Otolaryngology-Head and Neck Surgery recommends that BPPV be treated with canalith repositioning procedures (Epley maneuver) 3

Treatment Approach

• The American Academy of Otolaryngology-Head and Neck Surgery suggests that vestibular suppressant medications should NOT be used as they are inappropriate for BPPV 3
• Praxis Medical Insights recommends vestibular rehabilitation for persistent symptoms of vestibular neuronitis/labyrinthitis 4
• Praxis Medical Insights suggests that dietary sodium restriction, diuretics, and vestibular rehabilitation be used to treat Ménière's disease 4

Critical Pitfalls to Avoid

• Praxis Medical Insights warns that missing central causes, such as cerebellar strokes, can have serious consequences 1
• Praxis Medical Insights recommends avoiding the inappropriate use of vestibular suppressants in BPPV 3
• Praxis Medical Insights suggests that medication side effects be considered as a cause of dizziness in children on multiple medications 4