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对与运动相关脑震荡后出现头晕和平衡问题的儿童进行客观前庭测试。

Objective vestibular testing of children with dizziness and balance complaints following sports-related concussions.

作者信息

Zhou Guangwei, Brodsky Jacob R

机构信息

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Waltham, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Waltham, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Otolaryngol Head Neck Surg. 2015 Jun;152(6):1133-9. doi: 10.1177/0194599815576720. Epub 2015 Mar 27.

Abstract

OBJECTIVE

To conduct objective assessment of children with balance and vestibular complaints following sports-related concussions and identify the underlying deficits by analyzing laboratory test outcomes.

STUDY DESIGNS

Case series with chart review.

SETTING

Pediatric tertiary care facility.

SUBJECTS AND METHODS

Medical records were reviewed of 42 pediatric patients with balance and/or vestibular complaints following sports-related concussions who underwent comprehensive laboratory testing on their balance and vestibular function. Patients' characteristics were summarized and results analyzed.

RESULTS

More than 90% of the children with protracted dizziness or imbalance following sports-related concussion had at least 1 abnormal finding from the comprehensive balance and vestibular evaluation. The most frequent deficit was found in dynamic visual acuity test, followed by Sensory Organization Test and rotational test. Patient's balance problem associated with concussion seemed to be primarily instigated by vestibular dysfunction. Furthermore, semicircular canal dysfunction was involved more often than dysfunction of otolith organs. Yet, <10% of the children experienced a hearing loss following sports-related concussion.

CONCLUSIONS

Vestibular impairment is common among children with protracted dizziness or imbalance following sports-related concussion. Our study demonstrated that proper and thorough evaluation is imperative to identify these underlying deficits and laboratory tests were helpful in the diagnosis and recommendation of following rehabilitations.

摘要

目的

对运动相关脑震荡后出现平衡和前庭功能障碍的儿童进行客观评估,并通过分析实验室检查结果确定潜在缺陷。

研究设计

病例系列研究并进行图表回顾。

研究地点

儿科三级护理机构。

研究对象与方法

回顾了42例运动相关脑震荡后出现平衡和/或前庭功能障碍的儿科患者的病历,这些患者接受了全面的平衡和前庭功能实验室检查。总结了患者的特征并分析了结果。

结果

运动相关脑震荡后出现持续性头晕或平衡失调的儿童中,超过90%在全面的平衡和前庭评估中至少有1项异常发现。最常见的缺陷出现在动态视力测试中,其次是感觉统合测试和旋转测试。与脑震荡相关的患者平衡问题似乎主要由前庭功能障碍引起。此外,半规管功能障碍比耳石器官功能障碍更常见。然而,运动相关脑震荡后不到10%的儿童出现听力损失。

结论

在运动相关脑震荡后出现持续性头晕或平衡失调的儿童中,前庭功能损害很常见。我们的研究表明,进行适当而全面的评估对于确定这些潜在缺陷至关重要,实验室检查有助于诊断和后续康复建议。

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