学龄前儿童眩晕的病因分析及诊断方法的合理选择

Preschool children's vertigo:an investigation of etiologies and choice of appropriate diagnostic techniques

目的探讨学龄前儿童眩晕的常见病因、临床表现特点及合理的诊断方法。方法回顾性分析12例学龄前儿童眩晕的临床表现特点、诊疗经过、结果及家长对各项诊断方法的接受程度。结果 (1)12例患儿的诊断结果为:分泌性中耳炎3/12,儿童良性发作性眩晕3/12,内耳畸形3/12,良性阵发性位置性眩晕2/12,梅尼埃病1/12。(2)患儿年龄越小,典型的眩晕主诉越少,多表现为摔倒、行走不稳、行动笨拙、恐惧和害怕,能主诉眩晕的患儿最小年龄5.5岁,但所有患儿均未能描述眩晕细节。(3)各项诊断方法中,家长对眩晕问卷的接受度最高,对前庭功能检测技术接受度最低。结论学龄前儿童眩晕的常见病因有分泌性中耳炎、儿童良性发作性眩晕及内耳畸形,而5岁以下儿童很少以眩晕为主诉。儿童眩晕问卷有助于确认眩晕发作并了解病史细节,据此选择合适的诊疗技术。

Objective To identify common etiologies, clinical characteristics and appropriate diagnostic techniques in preschool children with vertigo. Methods The authors retrospectively analyzed the clinical characteristics, process ofdiagnosis and treatment in 12 vertigo-suffering children aging from 14 months to 6.5 years, and their parents＇ attitude to- ward the diagnostic techniques. Results （1） Etiologies of vertigo in the 12 children included secretory otitis media （SOM, n=3）, benign paroxysmal vertigo （BPV, n=3）, inner ear malformation （n=3）, benign paroxysmal positional vertigo （BPPV, n=2） and Meniere＇ s disease （MD, n=l）. （2） The younger the child, the fewer typical complaints of vertigo, in-stead of recurrent falls, difficulties in walking, poor balance and clumsiness, fear or panic. The youngest child that com- plained of vertigo was 5.5 years old. None of the children were able to describe the details of their vertigo episodes. （3） Among all the diagnostic techniques, vertigo questionnaire was the most acceptable to parents, and vestibular tests were the least. Conclusion Common etiologies of preschool children vertigo include SOM, BPV and inner ear malformation, Sufferers younger than 5 years seldom complain of vertigo. Vertigo questionnaires are powerful tools for clinicians in detecting vertigo and a thorough understanding of the history and symptoms helps the clinician in selecting appropriate diagnostic techniques.