Fried M P
Laryngoscope. 1980 Sep;90(9):1548-60.
A child with symptoms that relate to the balance mechanism can be a complex diagnostic problem. Often an adequate history is difficult to obtain because of the child's age and limitation of expression. Psychosomatic illness can frequently present as dizziness in children; however, this should not preclude a thorough evaluation. It is the purpose of this paper to outline these possibilities and the characteristics unique to each. The differential diagnosis can be grouped into central (central nervous system) and peripheral (otologic) categories, with a few miscellaneous conditions. A basic evaluation should include a complete neurotologic examination, audiogram and electronystagmogram. An electroencephalogram is frequently a valuable diagnostic adjunct. Further testing should be decided on the basis of the patient's history, examination and prior results. The records of children admitted to Boston City Hospital over a one-year period were reviewed. Of 2,088 pediatric patients, 238 had discharge diagnoses pertinent to the balance mechanism. Of these, 14 had a presenting symptom of dizziness. These cases are analyzed.
一个出现与平衡机制相关症状的儿童可能是一个复杂的诊断问题。由于儿童的年龄和表达能力有限，往往难以获得充分的病史。心身疾病在儿童中常表现为头晕；然而，这并不排除进行全面评估的必要性。本文旨在概述这些可能性以及每种情况的独特特征。鉴别诊断可分为中枢性（中枢神经系统）和外周性（耳科）类别，还有一些其他杂项情况。基本评估应包括全面的神经耳科检查、听力图和眼震电图。脑电图常常是一项有价值的诊断辅助检查。进一步的检查应根据患者的病史、检查和先前的结果来决定。对波士顿市医院一年内收治的儿童病历进行了回顾。在2088名儿科患者中，238名出院诊断与平衡机制相关。其中，14名有头晕的首发症状。对这些病例进行了分析。
