Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Akut Vertigo Semptomlu Pediatrik Hastaların Klinik ve Demografik Özelliklerinin Değerlendirilmesi: Tanımlayıcı Araştırma
Evaluation of Clinical and Demographic Characteristics of Pediatric Patients with Acute Vertigo Symptoms: Descriptive Research
Gül YÜCELa
aKonya Şehir Hastanesi, Çocuk Nörolojisi BD, Konya, Türkiye
Turkiye Klinikleri J Pediatr. 2022;31(3):151-9
doi: 10.5336/pediatr.2022-88518
Article Language: TR
Full Text
ÖZET
Amaç: Çocuklar özellikle okul öncesi dönemde yakınmalarını ifade etmekte zorlandıkları için vertigo tanısında sıkıntı yaşanmaktadır. Bu çalışmada akut vertigo yakınması ile başvuran pediatrik hastaların demografik ve klinik özellikleri ile etiyolojik nedenlerin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Konya Şehir Hastanesi Çocuk Nöroloji polikliniğine Ocak 2019-Temmuz 2021 tarihleri arasında akut vertigo şikâyeti ile başvuran 258 hastanın kayıtları retrospektif olarak değerlendirildi. Bulgular: Hastaların %64,7'i (n=167) kız, %35,3'ü erkek, kız/erkek oranı:1,84 idi. Yaşları 2,5-18 yıl arasında olup, ortalama yaşları 12,96 ±3,28 yıldı. Hastaların %40'ı (1-6 yaş), %17,8'i (6-12 yaş) çocuk ve %42,2'si (12-18 yaş) ergendi. Tüm hasta grubunda; çocukluk çağının benign paroksismal vertigosu (%21,3), ortostatik hipotansiyon (%20,5), migren ilişkili vertigo (%18,2), psikojenik vertigo (%14,7) ve epileptik vertigo (%6,2) en sık görülen tanılardı. Benign paroksismal vertigo ≤ 6 yaş çocuklarda en sık görülen tanı iken, ≥12 yaş ergenlerde psikojenik vertigo hâkimdi (p<0,001). Epileptik vertigo çocuk yaş grubunda daha yüksekti ve hastaların yarısının altı yaş altında olduğu saptandı. Epileptik vertigo hastalarında dalma, sabit boş bakma, tepkisizlik gibi farkındalığın bozulduğu fokal nöbetler tanımlandı (p<0,001). Sonuç: Çocuklarda benign paroksismal vertigo, ergenlerde psikojenik vertigo en sık görülen tanılardır. Epileptik vertigo küçük çocuklarda daha sık görülür. Nöbetler belirgin epileptik özellikler olmasa bile vestibüler bulgulara neden olabilir. Küçük çocuklar arasında vertigo ortaya çıktığında epilepsi de düşünülmelidir.

Anahtar Kelimeler: Vertigo; çocuk; ergen; baş dönmesi; ayırıcı tanı
ABSTRACT
Objective: There are difficulties in the diagnosis of vertigo because children have difficulty in expressing their vertigo complaints, especially in the pre-school period. In this study, it was aimed to evaluate the demographic and clinical characteristics and etiological causes of pediatric patients who presented with the complaint of acute vertigo. Material and Methods: The records of 258 patients who applied to the Konya City Hospital Pediatric Neurology outpatient clinic with the complaint of acute vertigo between January 2019-July 2021 were evaluated retrospectively. Results: Of the patients, 64.7% (n=167) were female, 35.3% male, female/male ratio was 1.84. Their ages were between 2.5-18 years, with a mean age of 12.96 ± 3.28 years. Of the patients, 40% (1-6 years), 17.8% (6-12 years) children, 42.2% (12-18 years) were adolescents. In the whole patient group; benign paroxysmal vertigo of childhood (21.3%), orthostatic hypotension (20.5%), migraine-associated vertigo (18.2%), psychogenic vertigo (14.7%) and epileptic vertigo (6.2%) were the most common diagnoses. Benign paroxysmal vertigo was the most common diagnosis in children ≤ 6 years of age while psychogenic vertigo prevailed in adolescent ≥12 years (p<0.001). Epileptic vertigo was higher in the pediatric age group and half of the patients were found to be under the age of six. Focal seizures with impaired awareness such as immersion, staring and unresponsiveness were defined in epileptic vertigo patients (p<0.001). Conclusion: Benign paroxysmal vertigo in children and psychogenic vertigo in adolescents are the most common diagnoses. Epileptic vertigo is more common in young children. Seizures may cause vestibular manifestations even without obvious epileptic features. Epilepsy should also be considered when vertigo emerged among younger children.

Keywords: Vertigo; child; adolescent; dizziness; differential diagnosis
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