Benign paroxysmal positional vertigo in pediatric age group: a review

Abstract

Vertigo is not common in the pediatric age group, but probably more often than was formerly thought. Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. It consists of the short duration of vertigo attacks found in a definite head position. The exact cause of BPPV is related to the idiopathic detachment of otoconia from the utricular membrane. The prevalence of BPPV in children is lower than in the adult age group. In children with BPPV, the symptoms consist of transitory rotational vertigo and torsional/ vertical/ horizontal or mixed nystagmus, depending on the position of the intra-labyrinthine otoliths, with latency and intensity in a typical crescendo-decrescendo pattern and it is exhaustible, reversible and fatiguing similar to adults. The diagnosis of BPPV can be accurately done by taking a detailed medical history, audiogram, and by use of positional testing. In children, BPPV can be successfully diagnosed and treated. In most cases, pediatric patients could not express details of their symptoms, and clinicians cannot always obtain adequate medical histories and determine their objective signs. So, it is not easy to study the BPPV in children. There are only a few articles describing BPPV in the pediatric age group, and therefore this subject is not well known to most otolaryngologists and clinicians. This review article discusses the epidemiology, etiopathology, clinical manifestations, diagnosis, and treatment of BPPB in the pediatric age group.