Categories

Pediatric Vestibular Disorders: Causes & Treatment

Pediatric Vestibular Disorders: Causes & Treatment

Pediatric Vestibular Disorders: Causes & Treatment

Key Takeaways

  • Children with vestibular disorders may experience delayed learning and symptoms such as blurred vision, dizziness, imbalance and frequent falls.
  • Some of the common disorders include Benign Paroxysmal Positional Vertigo (BPPV), Labyrinthitis or Vestibular Neuritis, Ménière’s Disease, and Secondary Endolymphatic Hydrops (SEH).
  • Vestibular rehabilitation is designed to take patients through a series of exercises that require them to use their eyes while their head is moving, and possibly when their body is moving.
  • Helping improve balance and safety with mobility, here are a few products that your pediatrician might recommend to you and your child.

Top Products in This Article

All kids, especially toddlers, stumble and fall sometimes. But your child may have a balance problem if you notice a regular pattern of issues like dizziness, blurred vision, clumsiness, and frequent falls. Your child’s pediatrician might recommend balance therapy. These exercises help with balance, reflexes, eye movement control, and more.

Learn more about the vestibular system and how vestibular rehabilitation therapy can help!

How Common Are Vestibular Disorders in Children?

Vestibular disorders are very common in children. About 1 in 20 children between the ages of 3 and 17 may be affected.1 Children with vestibular problems can be delayed in learning to sit, stand, and walk. These developmental delays often carry over as poorer balance skills throughout childhood.

The vestibular system makes up the parts of the inner ear and brain that process sensory information to control balance and eye movements. The inner ear is comprised of three parts: cochlea, semicircular canals, and vestibule (which contains the utricle saccule). The cochlea contains the nerves for hearing. The other two parts work together and send signals to the brain to help maintain posture and balance.

anatomy of the ear

Although common, vestibular disorders are not as easily recognized in children. For each child, symptoms will differ based on whether the damage is peripheral (inner ear), central (brain and brain stem), or both. The symptoms will also depend on whether there is a partial or complete loss of function.

Common Types of Vestibular Disorders

Dizziness, vertigo (sense of motion or spinning), and trouble with balance are the most common symptoms of vestibular disorder, however hearing and vision can also be affected.

Balance problems are different for every child. Some of the most common vestibular disorders include Benign Paroxysmal Positional Vertigo (BPPV), Labyrinthitis or Vestibular Neuritis, Ménière’s Disease, and Secondary Endolymphatic Hydrops (SEH).

  • Benign Paroxysmal Positional Vertigo (BPPV): causes vertigo and dizziness due to debris that has collected within a part of the inner ear. This debris, called otoconia, is made up of small crystals of calcium carbonate (known as “ear rocks”)1
  • Labyrinthitis and Vestibular Neuritis: occurs due to an infection that inflames the inner ear or the vestibulocochlear nerve. Neuritis, or inflammation of the nerve, results in dizziness or vertigo but no change in hearing. Labyrinthitis, or inflammation of the labyrinth, results in hearing changes as well as dizziness or vertigo.2
  • Ménière’s Disease: produces a repetitive set of symptoms as a result of large amounts of fluid (endolymph) collecting in the inner ear. These symptoms include vertigo, tinnitus, a feeling of fullness or pressure in the ear, and fluctuating hearing.3
  • Secondary Endolymphatic Hydrops: occurs due to quantity and pressure abnormalities of the inner-ear fluid. Sometimes this is a result of head trauma or ear surgery. It can also occur with other inner ear disorders, allergies, or systemic disorders.4

To learn more about vestibular disorders, watch this video!

Vestibular Rehabilitation Therapy

If your child complains of dizziness or trouble balancing, talk to your doctor about vestibular rehabilitation. Vestibular rehabilitation is an exercise-based program designed to improve balance and reduce dizziness-related problems. The three most common exercises you can practice at home with your child are the Epley Manuever, Semont Maneuver, and Brandt-Daroff Exercise.

Epley Maneuver

  1. Sit upright on a flat surface, with a pillow behind you and your legs outstretched
  2. Turn your head 45 degrees to the right. With your head still tilted, recline with your head on the pillow. Remain in this position for 30 seconds
  3. Slowly turn your head 90-degrees to the left, without lifting your neck
  4. Slowly return to neutral position, looking forward and sitting straight up

Semont Maneuver

  1. Sit upright on a flat surface, with a pillow behind you and with your legs outstretched
  2. Lie down, turning to your right, and look up towards your left side. Return to neutral position
  3. Sit up and turn to your left side, keeping your head facing to your left. You will now be looking down toward the ground
  4. Slowly return to neutral position, looking forward and sitting straight up

Brandt-Daroff Exercise

  1. Sit on a flat surface with your legs dangling as if you were sitting in a chair
  2. First, turn your head as far as you can to the left side. Then, lay your head and torso down on your right side. Remain in this position for 30 seconds
  3. Slowly sit up and turn your head back to neutral position
  4. Repeat this exercise on the opposite side. Turn your head as far as you can to the right side. Then, lay down on your left side

5 Vestibular Therapy Products to Use at Home

Tests can be used to assess the vestibular system and how well the inner-ear balance mechanism is working. Your child’s rehabilitation therapy program depends on the specific vestibular disorder and other health conditions. Exercise-based therapy can help train your child's brain to relearn how to balance and respond to signals from the vestibular and visual systems. Here are some products that you can use at home!

1. Tumble Forms 2 Balance Beam

Tumble Forms 2 Balance Beam

A beam provides hours of entertainment while helping to improve balance and motor skills. The versatility of this balance beam allows children to progress to more challenging balance work. The six-foot beam can be positioned to have the child walk on the narrow (3 inch) side or the wide (6 inch) side.

2. Universal Grasshopper System

Universal Grasshopper System

Prone or supine position can be used to develop improved head control and help prevent contractures and deformities in the lower extremities by facilitating hip extension, abduction and external rotation, knee extension, and ankle dorsiflexion. Side lying enables the child to achieve a beginning midline control that is important in motor and cognitive development. Both roll sitting and long leg sitting can be used to maintain or increase range of motion.

3. Tumble Forms 2 Rocker Balance Board

Tumble Forms 2 Rocker Balance Board

The rocker board helps children develop balance and strength in their core and legs. Use different positions on the balance board—such as a prone position versus a seated position—to test vestibular senses. Tumble Forms non-slip surface coating prevents the child from sliding while using the board.

4. Foam Steps

foam steps

These foam steps provide a slight unbalance that helps facilitate vestibular therapy. Designed for users who are developing or rehabilitating motor control or balance when changing levels. Sturdy, high-quality foam construction ensures safety and support.

5. Tumble Forms 2 Deluxe Vestibulator II System

Tumble Forms 2 Deluxe Vestibulator II System

To prevent any shifting balance, the platform of this swing attaches to the frame through four durable control lines. These control lines can be adjusted to increase or decrease the distance between the frame and the swing. Children can use the platform in a prone, cross-legged, kneeling, or supine position to stimulate sensory and vestibular functions.

Try Using Essential Oils

essential oils

Essential oils, when applied topically or inhaled, may help to ease the symptoms of vertigo. Some of the options available for managing vertigo include lavender and lemon as well as calming synergy. Essential oils can be inhaled through an infuser or diluted in a carrier oil before being applied topically.

Conclusion

Your child's body has two centers for balance control. One is located in the brain (central system) and one in the inner ear (peripheral system). The vestibular system is located in your child's inner ear. If your child has reoccurrences of blurred vision, dizziness, or trouble balancing, talk to your pediatrician about vestibular disorders.

Exercise-therapy can be used to improve balance and safety with mobility. It can also be used to improve adaptive responses to sensory input. If home therapy does not help, your doctor can prescribe medications and other treatments to lessen symptoms.

For more information on pediatric vestibular disorders, visit the Vestibular Disorders Association website.

References

  1. Anonymous. (2020). Ear Anatomy. VEDA. Retrieved from https://bit.ly/3bYMo4C
  2. Anonymous. (2020). Types of Vestibular Disorders: Benign Paroxysmal Positional Vertigo (BPPV). VEDA. Retrieved from https://bit.ly/39uwJbt
  3. Anonymous. (2020). Types of Vestibular Disorders: Labyrinthitis and Vestibular Neuritis. VEDA. Retrieved from https://bit.ly/3sF1Msl
  4. Anonymous. (2020). Types of Vestibular Disorders: Ménière’s Disease. VEDA. Retrieved from https://bit.ly/3cE7CVB
  5. Anonymous. (2020). Types of Vestibular Disorders: Secondary Endolymphatic Hydrops (SEH). VEDA. Retrieved from https://bit.ly/2Pg46rG
  6. Barhum, Lana. (2020). Home Remedies for Vertigo: Treatment and Epley Maneuver. Medical News Today. Retrieved from https://bit.ly/3paP4ju
  7. Hain, Timothy. (2011). What is Balance and Vestibular Rehabilitation Therapy? Brainline. Retrieved from https://bit.ly/2LWNxix

Medical Disclaimer: The information provided on this site, including text, graphics, images and other material, are for informational purposes only and are not intended to substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other healthcare professional with any questions or concerns you may have regarding your condition.