Lorente-Piera Joan, Pérez-Fernández Nicolás, Blanco-Pareja Melissa, Manrique-Huarte Raquel, Michael Larenas Pia, Serra Valeria, Manrique Manuel
Department of Otorhinolaryngology, Clínica Universidad de Navarra, 31008 Pamplona, Spain.
Department of Otorhinolaryngology, Clínica Universidad de Navarra, 28027 Madrid, Spain.
Audiol Res. 2024 Aug 14;14(4):701-713. doi: 10.3390/audiolres14040059.
Audiovestibular disorders in childhood occur with considerable frequency. However, the difficulty of obtaining medical history, the nonspecificity of symptoms, and the lack of cooperation during complementary tests often contribute significantly to diagnostic biases, attributing clinical presentations to psychosomatic disorders. The objectives of this work are, firstly, to characterize, from an auditory and vestibular perspective, the most frequent causes of vertigo in childhood and a possible relationship with emotional symptoms. On the other hand, to propose the usefulness of the MSSQ-Short questionnaire as a predictive variable in the evolution of children diagnosed with recurrent vertigo of childhood (RVC).
An observational cross-sectional study was designed with retrospective data collection at three tertiary hospitals.
Among the 117 patients recruited between 2016 and 2024, 32 patients (27.35%) were diagnosed with an anxious-depressive syndrome prior to audiovestibular testing. The mean age was 11.19 ± 5.61 years and the most frequent final diagnoses were vestibular migraine (VM) with 41.03% and RVC with 23.93%. Patients with VM, compared with RVC, are approximately 1.12 times more likely to have psychosomatic pathology (CI 0.39 to 3.25). The most sensitive and frequently altered test was VEMPS (39.32%), with statistical significance in VM and otic capsule dehiscence, while regarding the MSSQ-Short questionnaire, the linear regression of 0.28 indicates an increase in clinical duration with high questionnaire scores.
Vestibular disorders causing dizziness and vertigo are challenging to diagnose, often due to lack of cooperation and/or symptom nonspecificity. A thorough medical history and complementary tests, including audiovestibular and imaging studies, are advisable, thus avoiding systematically attributing children's complaints to other psychosomatic disorders.
儿童视听前庭疾病的发生率相当高。然而，获取病史的困难、症状的非特异性以及在辅助检查过程中缺乏配合，常常导致显著的诊断偏差，将临床表现归因于心身疾病。这项研究的目的，首先是从听觉和前庭的角度，对儿童眩晕的最常见原因及其与情绪症状的可能关系进行特征描述。另一方面，提出MSSQ-Short问卷作为诊断为儿童复发性眩晕（RVC）的儿童病情演变的预测变量的有用性。
设计了一项观察性横断面研究，在三家三级医院收集回顾性数据。
在2016年至2024年招募的117名患者中，32名患者（27.35%）在视听前庭测试前被诊断为焦虑抑郁综合征。平均年龄为11.19±5.61岁，最常见的最终诊断是前庭性偏头痛（VM），占41.03%，RVC占23.93%。与RVC相比，VM患者出现心身病理的可能性大约高1.12倍（置信区间0.39至3.25）。最敏感且经常出现异常的检查是视频眼震肌源性电位（VEMPS）（39.32%），在VM和耳囊裂开中具有统计学意义，而对于MSSQ-Short问卷，0.28的线性回归表明问卷得分高时临床病程会延长。
导致头晕和眩晕的前庭疾病诊断具有挑战性，通常是由于缺乏配合和/或症状非特异性。建议进行全面的病史采集和包括视听前庭及影像学检查在内的辅助检查，从而避免系统性地将儿童的症状归因于其他心身疾病。
