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Al-Makramani A, Shawish AM, Albarrati AM, Akkam MM, Hakami NM, Omar RN, Oraibi NM, Mubaraky AM, Humedi AM, Sufyani FA, Khodh AA, Arishi MA, Bahkali NI, Mannaa IA, Ahmed AE. Awareness and Knowledge of Parents and Caregivers Regarding Pediatric Obstructive Sleep Apnea in Jazan, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e64297. [PMID: 39131010 PMCID: PMC11316210 DOI: 10.7759/cureus.64297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2024] [Indexed: 08/13/2024] Open
Abstract
Background Pediatric obstructive sleep apnea (POSA) is a common sleep disorder that can cause major health problems if untreated. Parental knowledge and awareness are critical for early detection and management of POSA in children. This study sought to measure parents' and caregivers' knowledge and awareness of pediatric POSA in Jazan, Saudi Arabia, as well as to uncover sociodemographic correlates of knowledge levels. Methods This cross-sectional study was conducted in Jazan, Saudi Arabia. A structured survey was used to collect data on sociodemographic factors and knowledge of pediatric OSA. Data were examined using descriptive statistics, ANOVA, and multivariate logistic regression analysis. Results The study included 393 parents and caregivers, 36.4% of whom were in the 18-30 year age group. Most were Saudis (n=385; 98%), and 212 (53.9%) were men. Most parents (n=378; 96.2%) had limited knowledge of pediatric OSA. Significant knowledge gaps were observed in recognizing POSA symptoms, understanding its impact on children's academic performance, and their association with mental health issues. Internet and social networking sites were the most common sources of knowledge about POSA (n=131; 33.33%), followed by knowing someone with OSA (n=103; 26.21%). Parents with more than eight children had a significant association with more knowledge than those without children (adjusted OR = 10.661, 95% CI: 1.367-83.139, p = 0.024). Conclusion The study identified significant gaps in the recognition of POSA symptoms and understanding its impact on their children's academic performance and mental health. Despite their limited knowledge, parents were receptive to early intervention for POSA. The study suggests that parents with more children had better knowledge of POSA, indicating that experiential learning may contribute to their understanding. The study recommends developing and assessing targeted education and awareness programs for parents, healthcare providers, and the public to improve POSA diagnosis, care, and outcomes.
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Affiliation(s)
- Ali Al-Makramani
- Department of Pediatrics, Faculty of Medicine, Jazan University, Jazan, SAU
| | | | | | | | | | - Rawan N Omar
- College of Medicine, Jazan University, Jazan, SAU
| | | | | | | | - Fuad A Sufyani
- General Practice, Faculty of Medicine, Maastricht University, Maastricht, NLD
| | - Alfdl A Khodh
- Faculty of Medicine, Warsaw Medical University, Warsaw, POL
| | | | | | | | - Anas E Ahmed
- Community Medicine, Jazan University, Jazan, SAU
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Clark JE, Pate R, Rine RM, Christy J, Dalton P, Damiano DL, Daniels S, Holmes JM, Katzmarzyk PT, Magasi S, McCreery R, McIver K, Newell KM, Sanger T, Sugden D, Taveras E, Hirschfeld S. NCS Assessments of the Motor, Sensory, and Physical Health Domains. Front Pediatr 2021; 9:622542. [PMID: 34900852 PMCID: PMC8661476 DOI: 10.3389/fped.2021.622542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
As part of the National Children's Study (NCS) comprehensive and longitudinal assessment of the health status of the whole child, scientific teams were convened to recommend assessment measures for the NCS. This manuscript documents the work of three scientific teams who focused on the motor, sensory, or the physical health aspects of this assessment. Each domain team offered a value proposition for the importance of their domain to the health outcomes of the developing infant and child. Constructs within each domain were identified and measures of these constructs proposed. Where available extant assessments were identified. Those constructs that were in need of revised or new assessment instruments were identified and described. Recommendations also were made for the age when the assessments should take place.
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Affiliation(s)
- Jane E. Clark
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, United States
| | - Russell Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | | | - Jennifer Christy
- Department of Physical Therapy, University of Alabama, Birmingham, AL, United States
| | - Pamela Dalton
- Monell Chemical Senses Center, Monell Center, Philadelphia, PA, United States
| | - Diane L. Damiano
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, United States
| | - Stephen Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Denver, CO, United States
| | - Jonathan M. Holmes
- Department of Ophthalmology and Vision Science, University Arizona, Tucson, AZ, United States
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Susan Magasi
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Ryan McCreery
- Boys Town National Research Hospital, Boys Town, NE, United States
| | - Kerry McIver
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Karl M. Newell
- Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Terence Sanger
- Department of Biomedical Engineering, Neurology, and Biokinesiology, University of Southern California, Los Angeles, CA, United States
| | - David Sugden
- School of Education, University of Leeds, Leeds, United Kingdom
| | - Elsie Taveras
- Department of Pediatrics, Harvard Medical School and Mass General Hospital for Children, Boston, MA, United States
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Balzanelli C, Spataro D, Redaelli de Zinis LO. Benign Positional Paroxysmal Vertigo in Children. Audiol Res 2021; 11:47-54. [PMID: 33535402 PMCID: PMC7930952 DOI: 10.3390/audiolres11010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to assess the prevalence and analyze clinical parameters of benign positional paroxysmal vertigo (BPPV) in a pediatric age. A cohort of 423 children under the age of 15 (median age 11. interquartile range 9-13) was submitted to vestibular assessment for balance disorders. Dix-Hallpike and Roll-Supine tests were performed to look for positioning nystagmus using video-infrared goggles. BPPV was found in 43 of 423 children evaluated for balance disorders (10.2%). There were 28 females (65.1%) and 15 (34.9%) males. The posterior canal was involved in 79% of cases and the horizontal canal in 21% of cases. No apogeotropic bilateral or anterior canal form were seen. Thus, BPPV is not an infrequent type of vertigo in children and must be evaluated as soon as possible in order to plan the most appropriate maneuver and restore daily activities as soon as possible, avoiding anxiety and fear.
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Affiliation(s)
| | - Daniele Spataro
- ENT Department—ARNAS Garibaldi of Catania, 95123 Catania, Italy;
| | - Luca Oscar Redaelli de Zinis
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Section of Audiology, University of Brescia, 25123 Brescia, Italy
- Pediatric Otolaryngology Head Neck Surgery Unit, Children Hospital—ASST Spedali Civili of Brescia, 25123 Brescia, Italy
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Choi HG, Kim G, Kim BJ, Hong SK, Kim HJ, Lee HJ. How rare is benign paroxysmal positional vertigo in children? A review of 20 cases and their epidemiology. Int J Pediatr Otorhinolaryngol 2020; 132:110008. [PMID: 32240880 DOI: 10.1016/j.ijporl.2020.110008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/07/2020] [Accepted: 03/12/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The clinical features and incidence of benign paroxysmal positional vertigo (BPPV) are not well known in pediatric populations. The aim of this study was to describe the clinical characteristics of pediatric BPPV and to estimate the frequency of pediatric BPPV in the general population. METHODS We retrospectively reviewed the medical records of 20 children (6-14 years old) diagnosed with BPPV between 2007 and 2017. The age/sex distribution of BPPV for all ages at our hospital and in the Korean Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database were compared. The annual incidence and proportion of children with BPPV were calculated. RESULTS BPPV occurred 1.86 times more frequently in girls than in boys. Nine children (45%) had associated comorbidities, such as inner ear disorders and recent head trauma. The posterior and lateral semicircular canals were most commonly involved (n = 9 for each), and recurrence was observed in two patients (10%). Children younger than 15 years accounted for approximately 1% of all BPPV cases. The annual incidence of BPPV was 171.5/100,000 for all ages and 9.5/100,000 in the pediatric population. CONCLUSIONS Our findings suggest that pediatric BPPV is a relatively uncommon cause of vertigo in children and that the rates of related illness and recurrence are high.
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Affiliation(s)
- Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea; Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Gibbeum Kim
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Byeong Joon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Sung Kwang Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea; Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea; Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.
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Benign Paroxysmal Positional Vertigo (BPPV) in Children and Adolescents: Clinical Features and Response to Therapy in 110 Pediatric Patients. Otol Neurotol 2019; 39:344-350. [PMID: 29287036 DOI: 10.1097/mao.0000000000001673] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to characterize the clinical features and outcomes of benign paroxysmal positional vertigo (BPPV) in the pediatric population. STUDY DESIGN Retrospective case review. SETTING Tertiary care center. PATIENTS One hundred ten patients, aged 5 to 19 years old, diagnosed with BPPV. MAIN OUTCOME MEASURES Patient demographics, comorbidities, canal involvement, response to treatment, and incidence of recurrence. RESULTS BPPV was diagnosed in 19.8% of patients seen for dizziness during the study period. Patient age ranged 5 to 19 years old (mean =13.4 ± 3.4 yr). Female:male ratio was 3:2. The most prevalent comorbidities were concussion (n = 42, 38.2%) and migraine disorders (n = 33, 30.0%). Average time to diagnosis from symptom onset was 178.2 ± 190.8 days. The posterior canal was most frequently affected (n = 80, 72.7%), followed by the lateral canal (n = 37, 33.6%) and superior canal (n = 21, 19.1%), and 36.4% (n = 40) of patients had multiple canals affected. Treatment requiring more than or equal to five maneuvers to achieve resolution was observed in 11.8% of cases (n = 13). Recurrence was observed in 18.2% of cases. A logistic regression analysis demonstrated that patients with vestibular migraine or benign paroxysmal vertigo of childhood had five times higher odds of recurrence of BPPV, p = 0.003, 95% [1.735, 15.342], than those who did not have either. CONCLUSIONS BPPV is a relatively common cause of dizziness in the pediatric population. Children and adolescents with BPPV can be successfully treated with repositioning maneuvers but may be at risk for treatment resistance and recurrence. Increased awareness of BPPV in pediatric patients may reduce delays in identification and treatment.
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Hülse R, Warken C, Biesdorf A, Erhart M, Rotter N, Hörmann K, Wenzel A. Prävalenz peripher-vestibulärer Erkrankungen bei Kindern in Deutschland. HNO 2019; 68:360-366. [DOI: 10.1007/s00106-019-00747-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wenzel A, Eck S, Hülse K, Rohr K, Hörmann K, Umbreit C, Hülse M, Hülse R. Development of a new software and test setup for analyzing hVOR in very young children by vHIT. J Vestib Res 2017; 27:155-162. [DOI: 10.3233/ves-170611] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Wenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Simon Eck
- Biomedical Computer Vision Group, Department Bioinformatics and Functional Genomics, University of Heidelberg, IPMB, BioQuant, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kathrin Hülse
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karl Rohr
- Biomedical Computer Vision Group, Department Bioinformatics and Functional Genomics, University of Heidelberg, IPMB, BioQuant, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Karl Hörmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Claudia Umbreit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Jena, Jena, Germany
| | - Manfred Hülse
- Section of Phoniatrics, Pedaudiology and Neurootology, Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Roland Hülse
- Section of Phoniatrics, Pedaudiology and Neurootology, Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Okumura T, Imai T, Higashi-Shingai K, Ohta Y, Morihana T, Sato T, Okazaki S, Iwamoto Y, Hanada Y, Ozono Y, Imai R, Ohata K, Inohara H. Paroxysmal vertigo with nystagmus in children. Int J Pediatr Otorhinolaryngol 2016; 88:89-93. [PMID: 27497392 DOI: 10.1016/j.ijporl.2016.06.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A pathological nystagmus is an objective sign that a patient feels vertigo. However, there have been few opportunities to observe and record pathological nystagmus during a paroxysmal vertigo attack. Furthermore, it can be difficult to obtain cooperation in pediatric patients. We present two cases of paroxysmal vertigo in children in whom we successfully recorded and analyzed their pathological nystagmus during a vertigo attack. METHODS Of a total sample of 4349 patients seen at our hospital for dizziness in the last decade, a retrospective analysis revealed that 68 were children (<15 years old; 1.6%). Of these 68 children, we successfully identified pathological nystagmus during paroxysmal vertigo in only two (2.9%). RESULTS Case 1 was a 4-year-old girl. She felt vertigo the strongest when her left ear was down in the supine position. We observed and recorded her nystagmus during a vertigo attack with her mother's permission. Her positional nystagmus in the supine position was horizontal persistent apogeotropic nystagmus. Rightward nystagmus in the left-ear-down supine position was stronger than leftward nystagmus in the right-ear-down supine position. Therefore, the diagnosis was right lateral canal type of benign paroxysmal positional vertigo, of which the pathophysiology was cupulolithiasis. The other patient was an 11-year-old boy. He had a family history of migraines. His vertigo attacks occurred after onset of a severe migraine and lasted between 2 and 48 h. During an attack that we observed, he showed nystagmus, which was direction-fixed right torsional and rightward in darkness. His mother had noticed that his eyes moved abnormally and that his left eye did not shift to the left side when he looked leftward. He was old enough to clearly express his own symptoms. Other neurological examinations were normal. The diagnosis was vestibular migraine. CONCLUSIONS We analyzed a pathological nystagmus during paroxysmal vertigo in two children. We conclude that children can be diagnosed with a combination of careful history taking and accurate examinations of a pathological nystagmus.
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Affiliation(s)
- Tomoko Okumura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takao Imai
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Kayoko Higashi-Shingai
- Department of Otolaryngology, Suita Municipal Hospital, 2-13-20, Katayama-cho, Suita, Osaka 564-0082, Japan
| | - Yumi Ohta
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tetsuo Morihana
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takashi Sato
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Suzuyo Okazaki
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoriko Iwamoto
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yukiko Hanada
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshiyuki Ozono
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Ryusuke Imai
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazuya Ohata
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Abstract
PURPOSE The purpose of this case report is to present the cases of 2 boys with benign paroxysmal positional vertigo (BPPV). KEY POINTS Patient A (11 years old) and Patient B (9 years old) had complaints of vertigo with position changes. Both exhibited left torsion upbeating nystagmus in the left Dix-Hallpike (DH) test and complaints of vertigo with reproduction of their symptoms, indicating BPPV. Both were treated with a left canalith repositioning maneuver and reported decreased incidence of positional vertigo upon reevaluation. Scores on the Dizziness Handicap Inventory and the Visual Analog Scale for Dizziness decreased after treatment for 1 of the boys. CONCLUSION Benign paroxysmal positional vertigo is considered rare in children. Migraines may also cause vertigo. Differential diagnosis in these cases was made by performing the DH test. RECOMMENDATIONS FOR CLINICAL PRACTICE Children with vertigo should be screened for BPPV through use of history taking, and the DH test.
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Clinical experience with video Head Impulse Test in children. Int J Pediatr Otorhinolaryngol 2015; 79:1288-93. [PMID: 26117666 DOI: 10.1016/j.ijporl.2015.05.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND A standardized diagnostic protocol for children's vestibular assessment is still missing in daily clinical life. As rotatory chair testing and caloric test are usually not tolerated well by children, the aim of our study was not only to evaluate the importance and practicability of the video head impulse test performed in children with and without balance problems, but also to outline a diagnostic algorithm for children with balance problems. METHODS Fifty-five children aged 3-16 years have been included in this prospective monocentric study. Balance was assessed using results from health screening examinations of the participants and results from a specific dizziness questionnaire for children. The children were then divided in two groups: group I without any sign of vestibular development disorder and group II with possible signs for a pathological equilibrium development. Horizontal vestibulo-ocular reflex (HVOR) was assessed using a video-oculography system device (EyeSeeCam(©)). Gain at 40, 60, and 80ms and gain variance has been measured. Furthermore, it was evaluated how calibration of the system was tolerated by the participants, how the test itself was accomplishable in children, and which difficulties arose during testing. RESULTS Reproducible test results were accomplished in 42 children (75%). Children with no balance problems in history showed a median gain of 1.02 (±0.28). A significant gain reduction between 40 and 80ms was found (P<0.05). Catch-up saccades were found in none of the children. Children with balance problems had a significantly reduced gain. (0.47±0.3; P<0.05) In this group, catch-up saccades could be detected in 4 out of 6 patients. For both groups, performing the test approximately took 20min, which is significantly longer than in adults (P<0.05). Calibration of the system with laser dots was easily doable in children aged 6 and older, whereas children between 3 and 5 years had better calibration results using colorful little icons. CONCLUSIONS Video head impulse test is a sensitive and efficient vestibular test in children, which is tolerated well by children aged 3-16 years. Therefore, video head impulse test can be easily used as a screening tool to detect vestibular dysfunction in the pediatric population.
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Abstract
Benign paroxysmal positional vertigo (BPPV), the most common cause of dizziness, occurs in all age groups. It presents with vertigo on head movement, but in older patients presentation may be typical and thus accounting for a low recognition rate in the primary care setting. It may be recurrent in up to 50% of cases. BPPV is associated with displacement of fragments of utricular otoconia into the semicircular canals, most commonly the posterior semicircular canal. Otoconia are composed of otoconin and otolin forming the organic matrix on which calcium carbonate mineralizes. Otoconia may fragment with trauma, age, or changes in the physiology of endolymph (e.g., pH and calcium concentration). Presentation varied because otoconia fragments can be displaced into any of the semicircular canals on either (or both) side and may be free floating (canalolithiasis) or attached to the cupula (cupulolithiasis). Most cases of BPPV are idiopathic, but head trauma, otologic disorders, and systemic disease appear to be contributory in a subset. Positional maneuvers are used to diagnose and treat the majority of cases. In rare intractable cases surgical management may be considered. A strong association with osteoporosis suggests that idiopathic BPPV may have diagnostic and management implications beyond that of a purely otologic condition.
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Ergen B, Baykara M, Polat C. An investigation on magnetic imaging findings of the inner ear: A relationship between the internal auditory canal, its nerves and benign paroxysmal positional vertigo. Biomed Signal Process Control 2014. [DOI: 10.1016/j.bspc.2013.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
PURPOSE To determine reliability, diagnostic values, and minimal detectable change scores, 90% confidence (MDC90) of pediatric clinical tests of vestibular function. METHODS Twenty children with severe to profound bilateral sensorineural hearing loss and 23 children with typical development, aged 6 to 12 years, participated. The Head Thrust Test, Emory Clinical Vestibular Chair Test, Bucket Test, Dynamic Visual Acuity, Modified Clinical Test of Sensory Interaction on Balance, and Sensory Organization Test were completed twice for reliability. Reference standard diagnostic tests were rotary chair and vestibular evoked myogenic potential. Reliability, sensitivity, specificity, predictive values, likelihood ratios, and MDC90 scores were calculated. RESULTS Reliability ranged from an intraclass correlation coefficient of 0.73 to 0.95. Sensitivity, specificity, and predictive values, using cutoff scores for each test representing the largest area under the curve, ranged from 63% to 100%. The MDC90 for Dynamic Visual Acuity and Modified Clinical Test of Sensory Interaction on Balance were 8 optotypes and 16.75 seconds, respectively. CONCLUSIONS Clinical tests can be used accurately to identify children with vestibular hypofunction.
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