儿童和青少年眩晕与头晕综合征：临床表现与诊断路径
Vertigo and dizziness syndromes in children and adolescents: Clinical presentation and diagnostic pathway.
文献信息
| PMID | 42745351 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Doreen Huppert |
| 作者单位 | German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany. |
| 期刊 | Developmental medicine and child neurology |
| SCI 分区 | Q1 |
| IF | 4.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 对儿童和青少年眩晕与头晕综合征的诊断谱系提供全面概述，描述其不同的临床和仪器检查发现，并为“头晕儿童”提出合理的诊断方法，因为其潜在病因与成人不同，并可能对日常生活和社会活动产生显著影响。
方法： 这项前瞻性观察性队列研究分析了导致519名儿童/青少年眩晕或头晕的主要疾病，包括其人口学特征、临床表现和诊断发现。通过机器学习技术分析不同疾病的主要特征，以制定实用的诊断算法。
结果： 前庭性偏头痛是最常见的诊断（41%），其次是功能性头晕（18%）、儿童复发性眩晕（10%）、直立性头晕（6%）和发作性共济失调（3%）。此外，23%的儿童/青少年患有罕见疾病，例如脑肿瘤、遗传性/先天性疾病或感染。11岁以下儿童更常见儿童复发性眩晕，而青少年更常见儿童前庭性偏头痛。功能性头晕表现出与成人不同的独特特征，且对日常生活有高度影响。
解读： 儿童期和青少年期眩晕与头晕的诊断谱系广泛，必须与成人已知的临床表现和病因明确区分。尤其是在幼儿中，不同前庭综合征的临床表现可能相似，但独特的临床和神经眼科检查发现可导致正确诊断，并避免广泛且不必要的诊断性检查（例如磁共振成像）。
英文摘要
AIM: To provide a broad overview of the diagnostic spectrum of vertigo and dizziness syndromes in children and adolescents, to characterize distinct clinical and instrument-based findings, and to propose a reasonable diagnostic approach for the 'dizzy child', as the underlying causes differ from those in adults and may considerably affect daily living and social activities.
METHOD: This prospective observational cohort study analysed principal disorders that caused vertigo or dizziness in 519 children/adolescents for their demographics, clinical presentation, and diagnostic findings. The main characteristics of distinct disorders were analysed by machine learning techniques to develop a practical diagnostic algorithm.
RESULTS: Vestibular migraine was the most frequent diagnosis (41%), followed by functional dizziness (18%), recurrent vertigo of childhood (10%), orthostatic dizziness (6%), and episodic ataxia (3%). Furthermore, 23% of children/adolescents had a rare disorder, for example brain tumours, genetic/congenital disorders, or infections. Children younger than 11 years more commonly had recurrent vertigo of childhood and adolescents from vestibular migraine of childhood. Functional dizziness showed distinct characteristics and a high impact on daily living that differed from those in adults.
INTERPRETATION: The diagnostic spectrum of vertigo and dizziness in childhood and adolescence is broad and must be clearly differentiated from known clinical presentation and causes in adults. Especially in young children, clinical presentation may be similar in different vestibular syndromes, but distinct clinical and neuro-ophthalmological findings can lead to the correct diagnosis and avoid broad and unnecessary diagnostic procedures (e.g. magnetic resonance imaging).