ABSTRACT
Las alteraciones del equilibrio son una causa muy común de consulta en pacientes adultos pero mucho menos habitual en la población pediátrica. Cuando esta sintomatología aparece en los niños genera gran preocupación, tanto en los padres, como en los profesionales consultados. Objetivo: Exponer nuestra casuística en alteraciones del equilibrio en pacientes pediátricos y enunciar las patologías prevalentes dividiendo la muestra en grupos etarios. Materiales y Métodos: Se realizó un estudio retrospectivo, observacional, descriptivo y transversal. Se incluyeron pacientes entre 1 y 17 años que consultaron al servicio de otorrinolaringología de un Hospital Pediátrico de alta complejidad entre junio de 2014 y junio de 2017. Resultados: Se incluyeron en el estudio 247 pacientes entre 1 y 17 años; 123/247 (49%) niñas y 124/247 (51%) varones. La mediana de edad fue de 9 años. Los síntomas más frecuentes en la consulta fueron: vértigo (63/247); cefaleas (44/247) y la asociación de vértigo + cefaleas (43/247). Las patologías prevalentes fueron: cefaleas 55/247; cerebelitis aguda 30/247; vértigo paroxístico benigno de la Infancia 21/247; migraña vestibular 21/247. Conclusiones: Ante la presencia de un niño con alteraciones del equilibrio, es muy importante la historia clínica y un minucioso examen otoneurológico pensando en cada prueba qué área o sistema estamos evaluando y dónde estaría localizada la lesión (vía vestíbulo-ocular; vía vestíbulo-espinal, etc.). Es importante diferenciar, dado que es la causa de consulta más frecuente, que no todo paciente que presenta cefaleas y síntomas vestibulares asociados tiene como diagnóstico una migraña vestibular (AU)
Balance disorders are a common reason for consultation in adult patients but are much less frequent in children. When children present with these symptoms it causes great concern, both in the parents and in the professionals consulted. Objective: To present our series of pediatric patients with balance disturbance and to describe the different underlying disorders dividing the patients according to age. Material and methods: A retrospective, observational, descriptive and cross-sectional study was conducted. Patients between 1 and 17 years of age who consulted at the Department of Otolaryngology at a tertiary care hospital between June 2014 and June 2017 were included. Results: 247 patients between 1 and 17 years of age were included in the study; 123/247 (49%) girls and 124/247 (51%) males. Median age was 9 years. The most frequent symptoms at consultation were: Vertigo (63/247); Headaches (44/247), and an association of vertigo + headaches (43/247). The most common diagnosis were: headaches 55/247; acute cerebellitis 30/247; benign paroxysmal vertigo of childhood 21/247; vestibular migraine 21/247. Conclusions: In a child with a balance disorder, the diagnostic interview and a thorough oto-neurological examination are important considering what area or system is evaluated in each test and where the lesion may be located (vestibulo-ocular tract; vestibulo-spinal tract, etc.). Differentiation is important as, considering is the most frequent reason for consultation, not every patient who presents with headache associated with vestibular symptoms has vestibular migraine (AU)
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Headache , Migraine with Aura/diagnosis , Postural Balance , Prevalence , Vertigo , Vestibule, Labyrinth/physiopathologyABSTRACT
Objective To explore the clinical outcomes of vestibular rehabilitation therapy(VRT) in the treat‐ment of patients with balance disorders .Methods Seventy -six patients were diagnosed with vertigo based on the principle of single and double side targeted rehabilitation ,and were divided into four groups randomly .Group A of 29 cases received unilateral simple drug treatment only ,group B of 29 cases received unilateral drug treatmeat com‐bined with vestibular rehabilitation therapy ;bilateral simple drug treatment for the 9 cases in group C ,group D of 9 cases accepted bilateral drug treatment combined with vestibular rehabilitation therapy .Group A and C were the control groups while B and D were experimental groups .All cases were retrospectively analyzed to compare vestibu‐lar rehabilitation therapy combined with drugs treatment with the simple drug treatment group .Results The effects in all patients were better after treatment .The VSI scores four weeks after treatment in four groups were signifi‐cantly lower than that of before treatment .The BBS score after treatment of experimental groups were significantly higher than those of in the control groups .The Fukuda step experiment effects were better than the control group . All the above comparisons had a statistical significance(P< 0 .01) .Conclusion The clinical efficacy of normative vestibular rehabilitation exercise is satisfactory .
ABSTRACT
Balance disorders represent a growing concern due to the association with falls, particularly in elderly and patient with brain disorders. Balance disorders can occur when there is a disruption in any of the vision, vestibular sense, proprioception, muscle strength and reaction. Therefore, balance disorders may indicate various causes such as inner ear disorders, peripheral neuropathy, brain tumors, and brain injury including stroke. Also, aging itself is one of risk factor for balance disorder because there is a progressive loss of functioning of these systems in the elderly. However, disorder in any system may not mean the balance disorder, because balance is the result of several body systems working together. In addition to remediation of the disorder, balance training to enhance compensatory mechanism is an effective therapy for patients with balance disorder.