Imagine that you wake up one morning and the world around you is spinning rapidly as if you were on a merry-go-round. You try to walk but the floor seems to be moving and you fall to the ground. You begin to feel nauseous. You lie down hoping the feeling will disappear, but it does not.
It can be a terrifying experience for a child to experience dizziness. Moreover, it can often be very difficult for them to articulate to their parents and doctors exactly what they are experiencing.
Most pediatric health care providers do not learn about the evaluation and management of dizziness in children during the course of their training. A child complaining of dizziness may appear normal and may not have any obvious abnormalities on physical exam, but the differential diagnosis of dizziness in children is expansive, ranging anywhere from simple dehydration to a vestibular or balance disorder to a brain tumor. For these reasons, the evaluation of a child with dizziness can often be an intimidating and time-consuming task. …Read More
Concussion can impact more than just the brain
Most children will fully recover from a concussion within a few days, but many will have prolonged symptoms that can last for weeks or even months after their injury. This is known as post-concussion syndrome (PCS).
A 2011 study in the American Journal of Sports Medicine found that dizziness, the second most common symptom of PCS (headache is first) is the only on-field symptom of sports-related concussion predictive of PCS. The study also noted that high-school football players who experienced dizziness at the time they sustained their concussions were six times as likely to develop PCS as those who did not feel dizzy at the time of injury.
What is it about dizziness that is unique in concussion? …Read More
Dizziness is a definite challenge to evaluate in children. “One of the toughest things to figure out is, is it a problem with the vestibular system, or is it part of something else, a heart problem or an eye problem?” says Jacob Brodsky, MD, director of the Balance and Vestibular Program at Boston Children’s Hospital. “Then, the next challenge is determining whether it is an inner ear problem or a problem with the brain.”
A definitive answer often requires fancy equipment that generally isn’t available at pediatric centers. But with an ordinary bucket, an iPhone, an $18 app and some Velcro, Brodsky can quickly get a good indication of whether a child has a vestibular disorder — and specifically an inner ear problem.
The test is quick and simple: patients put their face in the bucket and turn it to “straighten” a vertical line displayed on an iPhone (affixed to the bottom of the bucket). The iPhone then calculates the patient’s subjective visual vertical (SVV), a measure of vestibular function. Brodsky hopes to see pediatricians, neurologists and otolaryngologists adopt this approach to do office-based testing.
Read more the iPhone + bucket test for vestibular dysfunction on our sister blog, Vector.