Balance Disorders in Children and Adolescents

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child Neurology".

Deadline for manuscript submissions: closed (10 February 2022) | Viewed by 17458

Special Issue Editors


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Guest Editor
1. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Section of Audiology, University of Brescia, 25123 Brescia, Italy
2. Pediatric Otolaryngology Head Neck Surgery Unit, Children Hospital—ASST Spedali Civili of Brescia, 25123 Brescia, Italy
Interests: otology; head neck surgery; hearing disorder; pediatric otolaryngology
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Guest Editor
Vertigo Center - San Bernardino Polyclinic of Salò, Italy
Interests: Audiology; Vestibology; children; otoneurology; Otorhinolaryngology

Special Issue Information

Dear Colleagues,

Balance disorders, at any stage of a child’s neurodevelopment, can be very debilitating, worsening their basic daily activities leading to self-isolation and the avoidance of normal recreational activities, with emotional, affective, physiological, and behavioral impairment, which could be permanent, sometimes influencing the whole future relationship to life. The prevalence data of the different forms of vertigo present in the scientific literature are highly variable. Vertigo may result from abnormalities of the labyrinth system or the central nervous system that spans from the vestibular nerve to the brainstem and cerebellum. When this symptomatology appears in children it is a cause for concern, both for parents and health professionals. Posterior fossa intracranial tumors are often considered in the differential diagnosis, but such serious causes are fortunately rare.

As with any dysfunction, the key to correct diagnosis is performing a complete history, physical examination, and further testing based on clinical indications. Obtaining an accurate history in young children may be difficult because of reduced communication skills of the child, their easy distraction and their inability to distinguish vertigo from fear. On the other hand, the parents may distort the situation according to their interpretation and concerns. The diagnostic work-up of balance diseases in pediatrics strongly depends on the age of the subject. Lack of knowledge about causes and the prevalence of balance disorders in children, their correlation with age and gender, and correct diagnostic work-up often leads to inappropriate, invasive, or expensive exams (i.e., CT or RMN), with no useful contribution to a proper therapeutic management. A correct diagnosis not only obviates unnecessary investigations and alleviates parental worries, but is also the prerequisite for successful therapy. The careful clinical examination of oculomotor and vestibular function is the key step on the way to diagnosis.

The general pediatrician, neuro-pediatrician, and neuro-otologist should be aware of the full spectrum of disorders in order to reach a correct diagnosis, leading to prompt and effective treatment.

The goal of this Special Issue is to highlight the current state of research on balance disorders in childhood, and we invite authors to submit manuscripts on all related topics.

 

Prof. Dr. Luca Redaelli de Zinis
Dr. Cristiano Balzanelli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Child/children
  • Childhood
  • Adolescent
  • Vertigo
  • Dizziness
  • Motion sickness
  • Imbalance
  • Peripheral vertigo
  • Central vertigo
  • Chronic vertigo
  • Balance
  • Vestibular
  • Nervous system
  • Neuro-otology
  • Differential diagnosis
  • Bedside evaluation
  • Video head impulse test/VHIT
  • Rotatory test
  • Caloric tests
  • Vestibular evoked myogenic potentials/VEMPS
  • Ocular VEMPS
  • Cervical VEMPS
  • Vestibular migraine
  • Vestibular paroxysmia

Published Papers (6 papers)

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Editorial

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3 pages, 458 KiB  
Editorial
Balance Disorders in Children and Adolescents
by Luca Oscar Redaelli de Zinis and Cristiano Balzanelli
Children 2022, 9(8), 1145; https://doi.org/10.3390/children9081145 - 29 Jul 2022
Viewed by 1423
Abstract
The prevalence of balance disorders in children and adolescents is extremely variable [...] Full article
(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)
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Research

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10 pages, 450 KiB  
Article
Visually Evoked Postural Responses (VEPRs) in Children with Vestibular Migraine
by Riccardo Nocini, Carlo Baraldi, Enrico Apa, Andrea Ciorba, Daniele Monzani and Silvia Palma
Children 2022, 9(1), 14; https://doi.org/10.3390/children9010014 - 27 Dec 2021
Cited by 4 | Viewed by 2607
Abstract
Vestibular migraine (VM) is the most common cause of episodic vertigo in children. Vertigo, nausea, dizziness and unsteadiness are often complained of by children with migraine, which can precede, follow or be present simultaneously with headache. The aim of this study was to [...] Read more.
Vestibular migraine (VM) is the most common cause of episodic vertigo in children. Vertigo, nausea, dizziness and unsteadiness are often complained of by children with migraine, which can precede, follow or be present simultaneously with headache. The aim of this study was to use posturography to investigate the visually evoked postural responses (VEPRs) of children with VM and compare them to data obtained from children with primary headache (M) and controls (C). Twenty children diagnosed as affected by VM, nineteen children with M without aura and twenty healthy subjects were recruited in this cross-sectional study. Posturography was performed by a standardized stabilometric force-platform (Svep-Politecnica) in the following conditions: open eyes (OE), closed eyes (CE) and during full-field horizontal optokinetic stimulation (OKN-S). Electronystagmography was performed simultaneously to analyze optokinetic reflex parameters. In the OE condition, no difference was found between groups with respect to body sway area. In contrast, this parameter increased in the two pathological groups with respect to controls in the CE condition. The optokinetic stimulations also induced a similar increase of body sway area in the M group relative to controls, but a further increase was elicited in the VM group. Electronystagmographic recording also revealed different optokinetic reflex parameters in the latter groups. This study disclosed an abnormal sensitivity of children with M and VM to full-field moving scenes and a consequent destabilization of posture, as documented by the abnormal VEPRs. Children with VM were particularly exposed to this risk. Possible clinical implications of these findings are discussed. Full article
(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)
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11 pages, 263 KiB  
Article
Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients
by Cristiano Balzanelli, Daniele Spataro and Luca Oscar Redaelli de Zinis
Children 2021, 8(11), 1056; https://doi.org/10.3390/children8111056 - 16 Nov 2021
Cited by 8 | Viewed by 1744
Abstract
(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from [...] Read more.
(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases. Full article
(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)
10 pages, 1205 KiB  
Article
Comparison of Lower and Upper Quarter Y Balance Test Performance in Adolescent Students with Borderline Intellectual Functioning Compared to Age- and Sex-Matched Controls
by Julian Bauer, Helena Kammermeier, Gerrit Schwiertz and Thomas Muehlbauer
Children 2021, 8(9), 805; https://doi.org/10.3390/children8090805 - 14 Sep 2021
Cited by 3 | Viewed by 2496
Abstract
The Lower (YBT-LQ) and Upper (YBT-UQ) Quarter Y Balance Test are well established assessment tools for the examination of dynamic balance and shoulder mobility/stability, respectively. However, investigations on YBT-LQ/UQ performance in students with borderline intellectual functioning (BIF) (i.e., intelligence quotient of 70–84 etc.) [...] Read more.
The Lower (YBT-LQ) and Upper (YBT-UQ) Quarter Y Balance Test are well established assessment tools for the examination of dynamic balance and shoulder mobility/stability, respectively. However, investigations on YBT-LQ/UQ performance in students with borderline intellectual functioning (BIF) (i.e., intelligence quotient of 70–84 etc.) are lacking. Thus, the aim of the study was to compare YBT-LQ/UQ performance in students with and without BIF. Thirty students with BIF (age: 13.7 ± 1.2 years) and 30 age-/sex-matched students without BIF (age: 13.7 ± 1.3 years) performed the YBT-LQ and/or YBT-UQ. Normalized maximal reach distances (% leg/arm length) per reach direction and the composite score were used as outcome measures. A univariate analysis of variance was conducted to test for significant group differences. Irrespective of limb and reach direction, students with BIF compared to those without BIF showed significantly worse YBT-LQ (p ≤ 0.001–0.031; Cohen’s d = 0.57–1.26) and YBT-UQ (p ≤ 0.001–0.015; Cohen’s d = 0.68–1.52) performance with moderate to large effect sizes. Due to the poorer performance levels of students with BIF, specifically tailored interventions should be developed that have the potential to improve their dynamic balance and shoulder mobility/stability. Full article
(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)
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Review

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16 pages, 410 KiB  
Review
The Pharmacological Treatment of Pediatric Vertigo
by Pasquale Viola, Gianmarco Marcianò, Alessandro Casarella, Davide Pisani, Alessia Astorina, Alfonso Scarpa, Elena Siccardi, Emanuele Basile, Giovambattista De Sarro, Luca Gallelli and Giuseppe Chiarella
Children 2022, 9(5), 584; https://doi.org/10.3390/children9050584 - 20 Apr 2022
Cited by 3 | Viewed by 4409
Abstract
Vertigo in children is a challenging topic. The lack of dedicated trials, guidelines and papers causes inhomogeneity in the treatment of vertigo in children. Meniere’s disease, migraine equivalents, vestibular neuritis, paroxysmal positional benign vertigo (BPPV), persistent postural-perceptual dizziness (PPPD) and motion sickness may [...] Read more.
Vertigo in children is a challenging topic. The lack of dedicated trials, guidelines and papers causes inhomogeneity in the treatment of vertigo in children. Meniere’s disease, migraine equivalents, vestibular neuritis, paroxysmal positional benign vertigo (BPPV), persistent postural-perceptual dizziness (PPPD) and motion sickness may affect children with various degrees of incidence and clinical severity compared to adults. Several drugs are proposed for the management of these conditions, even if their use is subordinated to the child’s age. In this review, we summarize the existing evidence related to the use of drugs for this clinical condition in children as a start point for new trials, stating the urgent need for international guidelines. Full article
(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)

Other

9 pages, 1094 KiB  
Perspective
Vertigo and Dizziness in Children: An Update
by Virginia Fancello, Silvia Palma, Daniele Monzani, Stefano Pelucchi, Elisabetta Genovese and Andrea Ciorba
Children 2021, 8(11), 1025; https://doi.org/10.3390/children8111025 - 08 Nov 2021
Cited by 13 | Viewed by 3539
Abstract
Background: Vertigo and dizziness are relatively infrequent in paediatric patients, but specific data on the prevalence of these disorders are limited and influenced by various factors, including the age of the examined population. These conditions often have a significant impact on patients’ and [...] Read more.
Background: Vertigo and dizziness are relatively infrequent in paediatric patients, but specific data on the prevalence of these disorders are limited and influenced by various factors, including the age of the examined population. These conditions often have a significant impact on patients’ and parents’ quality of life. The aim of this paper is to investigate the prevalence of different aetiologies of vertigo in the paediatric population through a systematic review. Methods: According to PRISMA guidelines, a systematic review of the literature was performed. Medline and Embase were searched from January 2011 through to 10 September 2021. The search yielded 1094 manuscripts, which were reduced to 7 upon the application of inclusion criteria. Results: A total of 2470 paediatric patients were evaluated by the selected papers. Vestibular Migraine was the most frequently diagnosed condition, occurring alone or in association with other diseases. Overall, audio-vestibular disorders represented the second cause of vertigo, and the prevalence appears to increase according to age growth. Over the years, even though we assisted in the amelioration of diagnostic rates, partially related to an improvement in diagnostic tools, the aetiology of vertigo remains still unclear in a variable percentage of patients. Conclusion: Vertigo in children, despite being an uncommon symptom, requires a multidisciplinary approach, often involving Paediatricians, Neurologists and Otorhinolaryngologists. A comprehensive evaluation of children suffering from vertigo is crucial for establishing a successful therapy and reducing parental worries. Full article
(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)
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