Zhang Jing, Guan Jing, Wang Hongyang, Zhang Jiao, Wang Dayong, Yang Dong, Zhou Huifang, Wang Qiuju
Department of Otolaryngology, Of Tianjin Medical University General Hospital, Tianjin, China.
Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology Head and Neck Surgery, The Sixth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.
Clin Otolaryngol. 2025 Sep;50(5):808-820. doi: 10.1111/coa.14323. Epub 2025 May 15.
Benign paroxysmal positional vertigo is a common cause of vertigo in adults but has been studied less extensively in children. Interestingly, the reported diagnostic frequency of benign paroxysmal positional vertigo in paediatric vertigo showed high variability. This systematic review and meta-analysis aimed to evaluate the proportion of benign paroxysmal positional vertigo in childhood vertigo and explore relevant factors to accurately diagnose BPPV in children.
Systematic review and meta-analysis.
PubMed, EMBASE database and Cochrane library (from 1 January 1962, to 12 April 2022) were searched for eligible studies analysing the proportion of benign paroxysmal positional vertigo in children with vertigo. Only papers published in English were included.
The pooled proportion of paediatric BPPV in childhood vertigo, and its corresponding 95% confidence interval (CI), were calculated. Additional subgroup analysis was performed by year of publication, testing techniques, department, regions, age and registering comorbidities of relevance for balance.
Ultimately, 26 studies were eligible for our meta-analysis. These studies involved 4043 childhood vertigo cases, of which 460 were BPPV. Based on the results of a random-effects model-based meta-analysis, the pooled proportion of benign paroxysmal positional vertigo in childhood vertigo was 5.5%. However, a subgroup analysis revealed a significantly higher pooled proportion of benign paroxysmal positional vertigo, with 9.9% in the videonystagmography subgroup and 17.1% in the comorbidity subgroup. Moreover, the proportion of BPPV varies among children with vertigo in different age groups.
In conclusion, the pooled proportion of BPPV in vertigo children was 5.5% across all samples. The present study revealed that age, applying VNG in positional testing, and comorbidity diagnosis may be closely related to the diagnosis of BPPV in children. Additionally, to prevent missed diagnosis of benign paroxysmal positional vertigo, diagnostic BPPV tests should not be neglected in children suffering from other vertigo-associated diseases.
良性阵发性位置性眩晕是成人眩晕的常见病因，但在儿童中的研究较少。有趣的是，报道的小儿眩晕中良性阵发性位置性眩晕的诊断频率差异很大。本系统评价和荟萃分析旨在评估儿童眩晕中良性阵发性位置性眩晕的比例，并探索准确诊断儿童良性阵发性位置性眩晕的相关因素。
系统评价和荟萃分析。
检索PubMed、EMBASE数据库和Cochrane图书馆（从1962年1月1日至2022年4月12日），以查找分析眩晕儿童中良性阵发性位置性眩晕比例的合格研究。仅纳入以英文发表的论文。
计算儿童眩晕中儿童良性阵发性位置性眩晕的合并比例及其相应的95%置信区间（CI）。通过发表年份、检测技术、科室、地区、年龄和登记的与平衡相关的合并症进行额外的亚组分析。
最终，26项研究符合我们的荟萃分析条件。这些研究涉及4043例儿童眩晕病例，其中460例为良性阵发性位置性眩晕。基于随机效应模型的荟萃分析结果，儿童眩晕中良性阵发性位置性眩晕的合并比例为5.5%。然而，亚组分析显示良性阵发性位置性眩晕的合并比例显著更高，视频眼震图亚组为9.9%，合并症亚组为17.1%。此外，不同年龄组的眩晕儿童中良性阵发性位置性眩晕的比例有所不同。
总之，所有样本中眩晕儿童中良性阵发性位置性眩晕的合并比例为5.5%。本研究表明，年龄、在位置测试中应用视频眼震图以及合并症诊断可能与儿童良性阵发性位置性眩晕的诊断密切相关。此外，为防止漏诊良性阵发性位置性眩晕，对于患有其他眩晕相关疾病的儿童，不应忽视良性阵发性位置性眩晕的诊断测试。
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