The vestibular system plays a critical role in normal motor development, motion tolerance, gaze stabilization (ability to focus with quick head movements – walking and jumping on a trampoline), postural control and alignment (balance abilities), spatial orientation, and vision. A vestibular system that is damaged by disease or injury in childhood prior to the maturation of the system can be more debilitating than the onset of vestibular dysfunction in adulthood.
Signs and symptoms of vestibular impairment depend on whether the damage is peripheral (inner ear) involving one (unilateral) or both (bilateral) ears, central (the brain) and a mixed lesion (peripheral and central).
Despite advances in testing and the documentation of vestibular deficits in children, vestibular disorders continue to be an overlooked entity in children; screening and testing for vestibular damage and pathology is seldom performed. Hence, vestibular dysfunction is not identified and many children are not receiving treatment, which we know may significantly improve their symptoms and function.
The most common causes of vestibular dysfunction in children are migraine, benign paroxysmal vertigo of childhood, trauma, malformation of the inner ear, visual and oculomotor deficits, vestibular neuritis, labyrinthitis, cochlear implantation, posterior fossa tumors, head injury, chronic otitis media, Benign Paroxysmal Positioning Vertigo, and bilateral vestibular impairment with concurrent sensorineural hearing loss. Vestibular deficits may arise from central nervous system disorders such as encephalitis and neuroblastomas.
Comprehensive testing is critical for accurate diagnosis and appropriate habilitation/rehabilitation and medical interventions, and requires a multi-disciplinary team approach.