title: Balance disorders in childhood: Main etiologies according to age. Usefulness of the video head impulse test.
abstract: Balance disorders are common in adult patients but less usual in the pediatric population. When this symptomatology appears in children it is a cause for concern, both for parents and health-care professionals.
  
  
  OBJECTIVE
  To explain the balance disorders in children describing a case series and to discuss the main etiologies found according to age.
  
  
  METHODS
  A retrospective, observational, descriptive, and cross-sectional study was conducted.
  
  
  METHODS
  Patients aged 1-18 years who consulted because of balance disorders at the otolaryngology department of a pediatric tertiary-care hospital between March 2012 and July 2015.
  
  
  RESULTS
  Two hundred and six patients were included in the study. Median age was 10 years. The most common diagnoses were vestibular migraine in 21.8% of the children, ataxia in 9.22%, benign paroxysmal vertigo of childhood in 7.77%, and post-traumatic vertigo in 6.31%.Overall, 61 videonystagmographies- of which 46 were normal - and 55 video head impulse tests - which were normal in 45 and showed abnormalities in the vestibulo-ocular reflex gain in 10 - were performed.
  
  
  CONCLUSIONS
  In a child with balance disorders, the medical history and neurotological examination are essential. Vestibular migraine is the most commonly found disorder in every age group, and most of the patients have a family history of migraine. Ancillary studies, especially the video head-impulse test, provide important data to confirm the diagnosis.
authors.affiliation: Otorhinolaryngology Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina. Electronic address: p.sommerfleck@gmail.com.
authors.forename: Patricia Alejandra
authors.initials: PA
authors.lastname: Sommerfleck
authors.affiliation: Otorhinolaryngology Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina. Electronic address: mariaemiliagonzalezmacchi@hotmail.com.
authors.forename: María Emilia
authors.initials: ME
authors.lastname: González Macchi
authors.affiliation: Neuro-otology Department, INEBA Instituto de Neurociencias de Buenos Aires, Argentina. Electronic address: romiwein@yahoo.com.
authors.forename: Romina
authors.initials: R
authors.lastname: Weinschelbaum
authors.affiliation: Otorhinolaryngology Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina. Electronic address: maxiddb@gmail.com.
authors.forename: Maximiliano Damián
authors.initials: MD
authors.lastname: De Bagge
authors.affiliation: Otorhinolaryngology Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina. Electronic address: patriciacbernaldez@hotmail.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: Bernáldez
authors.affiliation: Neuro-otology Department, INEBA Instituto de Neurociencias de Buenos Aires, Argentina. Electronic address: scarmona@ineba.net.
authors.forename: Sergio
authors.initials: S
authors.lastname: Carmona
mesh_terms: D000293:Adolescent; D001259:Ataxia / Q000150:complications / Q000503:physiopathology*; D065635:Benign Paroxysmal Positional Vertigo / Q000150:complications / Q000503:physiopathology*; D016543:Central Nervous System Neoplasms / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D064087:Head Impulse Test; D006801:Humans; D007223:Infant; D007762:Labyrinthitis / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000503:physiopathology*; D010034:Otitis Media with Effusion / Q000150:complications / Q000503:physiopathology*; D004856:Postural Balance; D012027:Reflex, Vestibulo-Ocular; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology*; D014717:Vertigo / Q000150:complications / Q000503:physiopathology; D015837:Vestibular Diseases; D014724:Vestibular Function Tests
keywords: Balance-disorder; Childhood; Video-head-impulse-test