VERTIGO is commonly seen in the childhood. The causes of vertigo in children and adults are different. It’s quite difficult to assess vertigo in children. Most of the physicians are unable to get enough history because children don’t tell their symptoms in details and so physician cannot get the exact etiology for the same. The benign paroxysmal vertigo is commonly seen in young children, since the vestibular migraine is the reason for vertigo in older children. Thus, paediatricians usually have trouble to get specific diagnosis of vertigo in children. For this it involves a detail history, clinical examination, complete neurological examination and audiological assessment. The treatment for vertigo in children by homoeopathic medicine has proved its effectivity time and again.
Vertigo, benign paroxysmal vertigo, vestibular neuritis, labyrinthitis, meniere’s disease, homoeopathy.
Vertigo or dizziness is feeling of light headiness, unsteady or spinning sensation. According to American Otolaryngology and Head and Neck Surgery Association, vertigo is a specific kind of dizziness expressed as an illusion of movement of oneself or the environment. Vertigo generally is classified as peripheral and central type based on the causes. Peripheral vertigo mainly arises from ear and has marked ear symptoms. Central vertigo arises from central nervous system. It may be have motor, sensory symptoms and also occasionally with audio and visual symptoms.
For children with Vestibular disorder its difficult to recognize because of their inability to describe symptoms well. Their immature anatomical structures may give a false impression on presenting symptoms. The parents should play an important role in the provision of extra information that will be useful in finding appropriate diagnosis. During general examination, it’s very much important to investigate about the developmental profile starting from pregnancy history, prenatal history and milestone development.
Proper development of vestibular system is responsible for the movement tolerance, control of postural alignment and vision. Impairment of function of the vestibular end organ may lead to vestibular dysfunctions which may be manifested as vertigo with or without associated symptoms.
Different diagnosis of vertigo in children is divided into peripheral, central and others. Peripheral vertigo include benign paroxysmal positional vertigo (BPPV), congenital deafness, immune mediated ear disease, infectious disease, post meningitis while central cause include childhood paroxysmal vertigo, cerebrovascular accident, hereditary ataxia, head trauma and multiple sclerosis.
Vertigo – (the feeling of spinning) sensation of sudden disorientation in space combined with a sensation of motion last for a minutes, days or weeks.
The many possible causes of vertigo include:
- Ear infections: the most common cause of vertigo is an ear infection. 2 common types of ear infections are:
- Vestibular neuritis.
- Meniere’s disease.
- Benign paroxysmal positional vertigo.
- Migraine (vestibular migraine).
- Head or neck injury/concussion.
- Vestibular disorders, or balance disorder relating to the inner ear .
- Brain tumor.
- Emotions like stress and anxiety.
- Psychogenic disorder (may cause psychogenic vertigo).
- Juvenile arthritis.
- Vestibular system is the part of the inner ear. It is made of the utricle, the sac clue, and 3 semi-circular canals.
- The vestibular system along with the visual pathway prevents blurring of vision during head movement. This is called the vestibule-ocular reflex.
- Disruption of the vestibular system can lead to vertigo and associated signs and symptoms.
Sign and symptoms
- Jerky eye movements.
- Tilting of the head.
- Trouble walking straight/poor balance.
- Pulling to one direction.
- Spinning feeling.
- Motion sickness.
- Sensitive for noise and light.
- Ringing in ears/tinnitus.
- Ear pain or fullness or pressure in the ears.
- Hearing loss.
Risk factors for vertigo in children
Children age 12 to 17:
- Pain in the neck and shoulder.
- Chronic stress.
- Assigned female at birth.
- Psychiatric disorders such as depression and anxiety.
Children ages 3 to 17:
- Difficulty hearing.
- Impairments that limit a child’s ability to crawl, walk or play.
- Frequent headache or migraine episodes.
- Developmental delays.
- Seizure in the past year.
Different risk factors according to gender
- Attention deficit disorder ( ADD)
- Attention deficit hyperactivity disorder (ADHD).
- Hearing difficulties.
- Respiratory allergies.
- CONIUM MACULATUM
- Vertigo with difficult gait.
- Trembling and palpitation.
- General weakness in the morning.
- Sudden loss of strength while walking.
- On lying down and turning over in bed.
- Slight noise of others and on shaking of head.
- COCCULUS INDICUS
- Vertigo with nausea and vomiting during travelling in bus, car or train.
- Sensation of emptiness in the head.
- Patient finds it difficult to lie on the back of the head.
- Occipital region is more sensitive and sensation of opening and shutting is present.
- Sever throbbing of the head associated with vertigo.
- The patient feels that he is falling to the left side or backward.
- Headache better by pressure.
- Vertigo with heavy eyelids and head with dim vision.
- Patient feels difficulty in walking with a loss of balance.
- Discomfort due to vertigo begins in the back of your head and then spreads from that point.
- Vertigo with gastric complaints like nausea and vomiting.
- Vertigo while changing the position of head and opening the eyes.
- Amelioration by lying down for a while and rest.
- Vertigo on slightest movement in any direction.
- General aggravation too on movement.
It is not uncommon for the children to be effected by vertigo. Management of vertigo in children should include a detailed history, clinical examination, audiological and neurological assessment.
The treatment for vertigo in children by homoeopathy is very effective. As homoeopathy is the holistic system of medicine, i.e. patient is considered as a whole and selection of a particular remedy based on similarity of symptoms presented by the patient is focused on.
- Devaraja K. Vertigo in children; a narrative review of the various causes and their management. International Journal of Pediatric Otorhinolaryngology. 2018 Aug 1;111:32-8.
- Choung YH, Park K, Moon SK, Kim CH, Ryu SJ. Various causes and clinical characteristics in vertigo in children with normal eardrums. International journal of pediatric otorhinolaryngology. 2003 Aug 1;67(8):889-94.
- Nelson Textbook of Paediatrics. Archives of Disease in Childhood [Internet]. 1983 Nov 1;58(11):942. Available from: https://doi.org/10.1136/adc.58.11.942-b
- Cnp JY, Cnp JY. Best Homeopathic Remedies for Vertigo and Dizziness. Doctors Health Press – Daily Free Health Articles and Natural Health Advice [Internet]. 2018 Nov 15; Available from: https://www.doctorshealthpress.com/homeopathic-remedies-for-vertigo-and-dizziness/ss