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Benign Paroxysmal Positional Vertigo of Childhood
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Seong Jun Choi, Dong Hyun Kim, You Ree Shin, Hun Yi Park, Tae Yun Kim, Yun Hoon Choung
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J Korean Bal Soc. 2006;5(2):269-273.
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 Abstract
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- Background
and Objectives: Episodic vertigo and/or dizziness in children are not frequent symptoms. Causes of benign episodic vertigo in pediatric age include bengin paroxysmal vertigo of childhood(BPV) and bengin paroxysmal positional vertigo(BPPV). While BPPV has been frequently observed in adult, less frequently observed in children. The aim is to review the clinical manifestations in children with BPPV.
Materials and Method: 154 children with dizziness or vertigo, who visited the Dizziness Clinic in the Department of Otolaryngology, Ajou University Hospital, Suwon, Korea between January 2001 and November 2006 were selected for this study. From all the patients, a comprehensive history was obtained, followed by clinical examination of the ears, nose, and throat and a complete audiologic and neurotologic examination including electronystagmography. All patients were treated with an appropriate canalith repositioning maneuver(CRP), depending on the type of BPPV.
Results
Seven (4.5%) of 154 children with dizziness or vertigo showed typical BPPV. The mean age was 11.8 years old (9-15 years). The horizontal and anterior semicircular canals were involved in 6 (85.8%) whereas the multiple semicircular canals were involved in 1 (14.2%) patients. Vertigo symptom subsided immediately in 6 (85.7%) patients after one or two trials of CRP, but 1(28.6%) patient showed recurred vertigo, that was treated with retrial of CRP.
Conclusion
The incidence of BPPV in children were much lower than that of adult BPPV, but it was higher than we expected before. We recommend that clinical tests such as Dix-Hallpike maneuver and head rolling test should be performed on all children with dizziness to establish the diagnosis of BPPV.
Key Words : Positional vertigo, Child
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The New Method to Determine the Causing Site of Horizontal Canal Benign Paroxysmal Positional Vertigo: “Bowing and Leaning Nystagmus”
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You Ree Shin, Hison Khang, Jung Sub Park, Seong Jun Choi, Keehyun Park, Yun Hoon Choung
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J Korean Bal Soc. 2006;5(1):55-60.
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Abstract
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- Background
and Objectives: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald’s second law. The purpose of this study is to develop the new “Bow and Lean Test (BLT)” to determine easily the affected ear of HSC-BPPV and evaluate its efficiency.
Materials and Method: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald's second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both “bowing nystagmus” and “leaning nystagmus” at head’s bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis.
Results
In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT.
Conclusion
“Bow and Lean Test” (also called “Choung’s test”) is a new method which can easily determine the affected ear of HC-BPPV.
Key Words : Vertigo, Benign paroxysmal positional vertigo, Horizontal semicircular canal, iagnosis, Nystagmus
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Analysis of the Vestibular Function in Children with Otitis Media with Effusion
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in Jung Cho, Keehyun Park, You Ree Shin, Yun Hoon Choung
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J Korean Bal Soc. 2005;4(2):212-218.
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Abstract
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- Otitis media with effusion (OME) is one of the most common diseases in children and may be frequently related with dizziness. Background and Objectives: However, the association between OME and dizziness seems to be not clear and remains controversy. The purpose of this study was to determine the incidence of dizziness in children with long lasting OME, and to investigate the difference in vestibular functions between children with long lasting OME and the control group.
Materials and Method: Thirty one children who had long-lasting OME over than 6 months (study group) and 28 normal hearing children without OME who were scheduled for adenotonsillectomy (control group), were given questionnaires and vestibular function tests (VFT) including electronystagmography (ENG) and rotation chair test(RCT). Statistical analysis was performed with chi-square test.
Results
Dizziness was found in 7 (22.6%) of 31 children in the study group and 2 (7.1%) of 28 children in the control group (p>0.05). The difference of abnormal findings in VFT between the study group and the control was not significant except visual vestibulo-ocular reflex (VVOR) in RCT. Most of the correlations in the study group, bilateral vs. unilateral OME, OME with dizziness vs. OME without dizziness, and preoperative vs. postoperative, were not significant.
Conclusion
We did not find any evidences of significant difference of the incidence of dizziness and findings of VFT between children with long lasting OME and children without OME. However, there was a significant abnormal response in VVOR in RCT in children with long-lasting OME, suggesting the children with OME may be more dependent on the nonvestibular system including visual compensation to maintain balance.
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Acute Vestibular Neuritis in Children
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You Ree Shin, Yun Hoon Choung, Yoon Tae Kim
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J Korean Bal Soc. 2005;4(1):53-57.
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Abstract
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- The acute vestibular neuritis is rarely seen in children and it is hard to find the related reports. In this paper, we report three cases of acute vestibular neuritis less than 15 years old that we experienced during last 10 years. The three cases are 14 and 11-year old boys and a 12-year-old-girl. They complained vertigo without hearing loss. Only one of three cases had previous common cold history and they showed all negative reactions in virus blood tests. After medical treatment and early rehabilitation, vertigo was completely controlled within 3 weeks and there was no recurrent symptoms so far. This recovery in children seems to be faster and more complete than in adults.
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