Department of Otorhinolaryngology, San Gerardo Hospital, Monza, Italy.
Department of Otorhinolaryngology, San Gerardo Hospital, Monza, Italy; Department of Otorhinolaryngology, University of Milano-Bicocca Faculty of Medicine and Surgery, Monza, Italy.
J Int Adv Otol. 2022 Mar;18(2):177-182. doi: 10.5152/iao.2022.20087.
Benign paroxysmal positional vertigo is a rare vestibular disorder in the pediatric population. It is a vestibulopathy characterized by brief attacks of vertigo, which occur after specific movements. This review aims to provide the current evidence regarding benign paroxysmal positional vertigo in children. This is a narrative review of the available literature on benign paroxysmal positional vertigo in children. The studies were retrieved from systematic searches on PubMed and by cross referencing. Few studies have focused on pediatric benign paroxysmal positional vertigo, and most are retrospective non-controlled studies that include a small number of children. The vast majority of cases of benign paroxysmal positional vertigo in children have been reported to be secondary. The most frequent forms involve the posterior canal and the horizontal canal. The diagnosis is based on positional maneuvers, respectively the Dix-Hallpike maneuver, which reveals a torsional upbeating nystagmus; and the supine roll test, which reveals a geotropic, horizontal nystagmus. The treatment consists of physical repositioning maneuvers: the Semont or the modified Epley maneuver for benign paroxysmal positional vertigo involving the posterior canal and the Gufoni or the Barbecue maneuver in case of the horizontal canal. Benign paroxysmal positional vertigo in children can be resistant to treatment and repetitive positional maneuvers may be necessary, particularly for children with vestibular migraine or benign paroxysmal vertigo of childhood, who have a statistically significant major risk of having recurrences compared to patients who do not. Benign paroxysmal positional vertigo in children is a rare but well-recognized clinical entity. It is diagnosed by positional testing and treated by repositioning maneuvers. Wide awareness and education among pediatric providers and otolaryngologists are needed in order to avoid a delay in identification and treatment.
良性阵发性位置性眩晕是儿童期罕见的前庭障碍。它是一种以短暂眩晕发作为特征的前庭疾病，这些眩晕发作发生在特定运动后。本综述旨在提供关于儿童良性阵发性位置性眩晕的当前证据。这是一篇关于儿童良性阵发性位置性眩晕的现有文献的叙述性综述。这些研究是通过对 PubMed 的系统搜索和交叉引用检索到的。很少有研究关注儿科良性阵发性位置性眩晕，而且大多数是回顾性非对照研究，只包括少数儿童。大多数儿童良性阵发性位置性眩晕被报道为继发性。最常见的形式涉及后管和水平管。诊断基于位置动作，分别是 Dix-Hallpike 动作，该动作揭示扭转性上跳性眼球震颤；以及仰卧位滚动试验，该试验揭示了向地性、水平性眼球震颤。治疗包括物理复位动作：对于涉及后管的良性阵发性位置性眩晕，使用 Semont 或改良 Epley 手法；对于水平管，使用 Gufoni 或 Barbecue 手法。儿童良性阵发性位置性眩晕可能对治疗有抵抗力，可能需要重复进行位置动作，特别是对于前庭性偏头痛或儿童良性阵发性眩晕的儿童，与没有这种情况的患者相比，他们有统计学上显著的复发性高风险。儿童良性阵发性位置性眩晕是一种罕见但公认的临床实体。它通过位置测试诊断，并通过复位动作治疗。儿科医生和耳鼻喉科医生需要广泛的认识和教育，以避免识别和治疗的延迟。
