In a previous blog post (which you can find here), we discussed dizziness in the adult population. But what about when a child complains of dizziness? Should we be concerned? How do you know where to take the child for further evaluation?

How common is it?

A study in 2010 published in the International Journal of Pediatric Otorhinolaryngology (see footnote 1) found that 6% of children (or about 1 in 20) up to the age of 10 have experienced significant degrees of dizziness. That’s a fairly high prevalence – it’s at least one person in your child’s class at school.

What are the most common causes?

According to another research paper published in the journal of Pediatric Neurology (see footnote 2), the most common causes of dizziness are:

  • Migraine (39%)
  • Benign Paroxysmal Vertigo, or BPV (16%)
  • Infection, such as vestibular neuronitis or labyrinthitis (14%). This is a viral infection of the inner ear and/or the vestibular nerve
  • Anxiety (13%)

These 4 account for approximately 80% of cases of dizziness in children. The remaining 20% are primarily made up of:

  • Orthostatic hypotension (getting dizzy when standing up too quickly)
  • Concussion
  • Seizure
  • Syncope (conditions that lead to fainting)

There are some other causes, however these are much less common. They include more sinister (and again I stress, much less common!) things such as tumours, vascular disorders or a condition of the inner ear known as Meniere’s disease.

Should I be worried if my child is suffering dizziness?

In short, no. Most of the time it’s nothing too serious, although it shouldn’t be ignored. Proper examination and monitoring should be undertaken.

Here at our clinic we see children with dizziness quite often, and our diagnostic approach is fairly simple yet thorough. The main things we want to ask about when we examine dizziness (and some of these are things that you can even check for yourself) are:

  1. The nature of the symptoms: are the attacks of dizziness acute (sudden, short term) in nature, or are they more chronic, vague, long-term episodes? Acute or sudden attacks tend to be suggestive of migraine attacks, inner ear infection, anxiety attacks, vascular events or BPV. We also want to differentiate between light-headedness (ie. a feeling that you’re about to faint) or true vertigo (a sensation of spinning or constant movement). Light-headedness and vertigo both usually get referred to as “dizziness”, but the causes of these two are quite different.
  2. Are there any auditory changes? (ie. hearing loss or tinnitus). This would confirm the involvement of the vestibular nerve.
  3. Are there any associated symptoms that occur at the same time or shortly after the dizzy episodes? eg. headache, fever, vomiting, balance disturbance, anxiety, changes in consciousness.

Once we find the answers to these questions, our physical and neurological examination includes:

  • Observation of walking and gait
  • Balance & coordination
  • Cranial nerve testing
  • Motor testing
  • Sensory testing

How can a chiropractor help with my child’s dizziness?

Just like in an adult, a child’s brain is constantly receiving sensory information from a multitude of sources all the time. Some of these pieces of sensory information are designed to tell the brain where all of the body parts are in space and whether they’re moving in a particular direction. If there is a loss of sensory input or there is some confusion between two or more inputs, the brain will lose perception of where the body is located, and a feeling of dizziness will ensue.

Chiropractic treatment for dizziness is aimed primarily at restoring normal sensory feedback from the incredibly neurologically-rich structures of the spine, in particular the neck. Increasing proprioceptive feedback from the spine via gentle mobilisations and adjustments will aid in regaining that sense of stability and awareness, as the higher centres of the brain are able to calculate the body’s position more accurately (see this blog post for more info on that concept).

Also, as mentioned above, seeing us for assessment of your child’s dizziness is important. It may end up being something that we’re not equipped to help with, but our expertise in examining it will make sure you are pointed in the right direction if necessary.

Will my child need a brain scan or MRI?

Most of the time, no. Only in very rare cases would we suspect something sinister like a brain tumour or a vascular disorder, in which case imaging like this would be essential. But we rule out all other likely causes before we suspect something that would require further investigation with an MRI. That said, however, we will not hesitate to look further if we need to and if the signs and symptoms point us in that direction.

For any questions please feel free to call us on 9743 2311, or email me directly at ian@chrcentre.com.au. Alternatively book an appointment (you can do so online by clicking here) and let one of us take a look.

Dr Ian Lawson (chiropractor)

 

References:

1) Humphriss RL & Hall AJ; Dizziness in 10 year old children: An epidemiological study; Int J Pediatr Otorhinolaryngol. 2011 Mar;75(3):395-400

2) Ravid S, Bienkowski R & Eviatar L; A simplified diagnostic approach to dizziness in children; Pediatr Neurol. 2003 Oct;29(4):317-20.

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