Vestibular disorders in children are significant causes for childhood morbidity with various manifestations that are often unrecognised or undiagnosed. Dizziness/vestibular symptoms are usually managed by community and general paediatricians and paediatric neurologists or neurotologists and surgeons who primarily deal with adults.
Dedicated paediatric neurotologists require training in all aspects of paediatric diseases to develop an insight for a holistic approach for management that is crucial for best outcomes. It is also important to recognise the close overlap with paediatric neurology and indeed, a robust knowledge in neurology is essential to practice paediatric neurotology. A child is not a miniature adult and indeed vestibular physiology differs from adults.
The system anatomically is fully formed in utero and at birth, however, central connections mature up to the age of 8 years and become adult like at around 15 years of age. The processes are metabolically more active and the otic capsule is still attaining structural integrity. Therefore, adult norms for different vestibular quantification tests are not applicable.
Anamnesis is considered vital and the most crucial element of a diagnostic algorithm for vestibular disorders in adults. This is achieved mainly through verbal communication that may be difficult or in some instances impossible to obtain from children. Thus, paediatric neurotologists need to improvise and glean the history from carers with leading questions relating to daily activities of children. In addition, a detailed history regarding the child in general needs to be enquired for example birth and development history that are not necessary in adults.
The aetiological profile for peripheral and central disorders is markedly different from that in adults. For example, vestibular migraine is the commonest paediatric vestibular affliction; third window disorders in children may follow a different trajectory than adults; idiopathic Meniere’s disease and benign positional paroxysmal
vertigo are very rare. The diagnostic algorithm with latest technology is also different as children are far more difficult to test as compared to adults. Examining a child is really an art that can come from years of experience and the knowledge about the paediatric vestibular system and its development.
Following diagnosis, treatment might follow a different course than adults and it is crucially important to acknowledge this. Management is holistic and directed to the overall child rather than just the vestibular system and is multidisciplinary including a cognitive approach. The outcome is usually very successful and rewarding.
We are launching a Research Topic on diagnosis and management of Vestibular Disorders in Children. It is time that we raise awareness about this important subject and address it. We are confident that this Research Topic will add to knowledge to our understanding in the field and provide us with valuable insights on managing such children.
For this Research Topic, we aim to bring together recent and innovative diagnostic formulations and management of vestibular disorders in children including both common and exotic diagnoses. We also aim to bring in latest ideas about the vestibular system on the overall development in children including cognitive aspects and the role of the vestibular system on such development, and welcome all types of manuscripts.
Vestibular disorders in children are significant causes for childhood morbidity with various manifestations that are often unrecognised or undiagnosed. Dizziness/vestibular symptoms are usually managed by community and general paediatricians and paediatric neurologists or neurotologists and surgeons who primarily deal with adults.
Dedicated paediatric neurotologists require training in all aspects of paediatric diseases to develop an insight for a holistic approach for management that is crucial for best outcomes. It is also important to recognise the close overlap with paediatric neurology and indeed, a robust knowledge in neurology is essential to practice paediatric neurotology. A child is not a miniature adult and indeed vestibular physiology differs from adults.
The system anatomically is fully formed in utero and at birth, however, central connections mature up to the age of 8 years and become adult like at around 15 years of age. The processes are metabolically more active and the otic capsule is still attaining structural integrity. Therefore, adult norms for different vestibular quantification tests are not applicable.
Anamnesis is considered vital and the most crucial element of a diagnostic algorithm for vestibular disorders in adults. This is achieved mainly through verbal communication that may be difficult or in some instances impossible to obtain from children. Thus, paediatric neurotologists need to improvise and glean the history from carers with leading questions relating to daily activities of children. In addition, a detailed history regarding the child in general needs to be enquired for example birth and development history that are not necessary in adults.
The aetiological profile for peripheral and central disorders is markedly different from that in adults. For example, vestibular migraine is the commonest paediatric vestibular affliction; third window disorders in children may follow a different trajectory than adults; idiopathic Meniere’s disease and benign positional paroxysmal
vertigo are very rare. The diagnostic algorithm with latest technology is also different as children are far more difficult to test as compared to adults. Examining a child is really an art that can come from years of experience and the knowledge about the paediatric vestibular system and its development.
Following diagnosis, treatment might follow a different course than adults and it is crucially important to acknowledge this. Management is holistic and directed to the overall child rather than just the vestibular system and is multidisciplinary including a cognitive approach. The outcome is usually very successful and rewarding.
We are launching a Research Topic on diagnosis and management of Vestibular Disorders in Children. It is time that we raise awareness about this important subject and address it. We are confident that this Research Topic will add to knowledge to our understanding in the field and provide us with valuable insights on managing such children.
For this Research Topic, we aim to bring together recent and innovative diagnostic formulations and management of vestibular disorders in children including both common and exotic diagnoses. We also aim to bring in latest ideas about the vestibular system on the overall development in children including cognitive aspects and the role of the vestibular system on such development, and welcome all types of manuscripts.
