title: Vestibular neuritis in children and adolescents: Clinical features and recovery.
abstract: OBJECTIVE
  Describe the clinical presentation and recovery of vestibular neuritis in children and adolescents.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Pediatric tertiary care center.
  
  
  METHODS
  Eleven patients diagnosed with vestibular neuritis were identified from a database of 301 patients evaluated at our pediatric vestibular clinic from January 2012 through January 2015. Medical records were reviewed to determine clinical presentation, vestibular testing results, treatment, and recovery. Incomplete recovery was defined as residual dizziness or imbalance at most recent follow-up >30 days from symptom onset.
  
  
  RESULTS
  Patients were 5-19 years old (mean 13.1±5.34) and included 6 boys and 5 girls. All presented with a sudden rotational vertigo, imbalance, and nausea for an average of 10 days without other associated symptoms. Testing included rotary chair (8 of 9 abnormal), caloric (2 of 2 abnormal), video head impulse (5 of 8 abnormal), subjective visual vertical (4 of 8 abnormal), and cervical vestibular evoked myogenic potential (0 of 6 abnormal) tests. All patients with incomplete recovery (n=4; 36%) were ≥15 years old at symptom onset. All patients with incomplete recovery that underwent vestibular rehabilitation (n=2) initiated it ≥90 days from symptom onset, while 3 out of 4 patients with complete recovery that underwent vestibular rehabilitation initiated it ≤14 days from symptom onset. Two patients received oral steroids, neither of whom had incomplete recovery.
  
  
  CONCLUSIONS
  Vestibular neuritis should be considered in pediatric patients with vertigo and may result in longstanding symptoms, particularly in adolescents. The treatment of pediatric vestibular neuritis with rehabilitation and steroids deserves further study.
authors.affiliation: Department of Otolaryngology and Communication Enhancement (J.R.B., B.A.C., GW.Z.), Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology (J.R.B., GW.Z.), Harvard Medical School, Boston, MA, USA. Electronic address: jacob.brodsky@childrens.harvard.edu.
authors.forename: Jacob R
authors.initials: JR
authors.lastname: Brodsky
authors.affiliation: Department of Otolaryngology and Communication Enhancement (J.R.B., B.A.C., GW.Z.), Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology (J.R.B., GW.Z.), Harvard Medical School, Boston, MA, USA.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Cusick
authors.affiliation: Department of Otolaryngology and Communication Enhancement (J.R.B., B.A.C., GW.Z.), Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology (J.R.B., GW.Z.), Harvard Medical School, Boston, MA, USA.
authors.forename: Guangwei
authors.initials: G
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014717:Vertigo / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D014724:Vestibular Function Tests / Q000379:methods; D020338:Vestibular Neuronitis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D014722:Vestibule, Labyrinth / Q000503:physiopathology; D055815:Young Adult
chemical_list: D005938:Glucocorticoids
keywords: Vestibular neuritis; Vestibular neuronitis, Pediatric dizziness, Pediatric vestibular testing, Childhood vertigo, Video head impulse test