Last modified: 2014-04-03
Abstract
Background: It is well established that vestibular injury can occur with traumatic brain injury (TBI). Symptoms that could be related to vestibular dysfunction rather than a brain injury include vertigo, dizziness, and imbalance. Reports indicate that the incidence of dizziness or imbalance secondary to vestibular dysfunction may occur in up to 83% of adults following mild TBI but there are few studies examining this in children. It is difficult, but clinically very relevant, to differentiate symptoms due to vestibular injury as the treatment is very different.
Objective: 1) To examine the symptom of dizziness in children with TBI and 2) Investigate the prevalence of vestibular dysfunction in children following a TBI using a novel diagnostic technique.
Methods: Prospective cohort study. Population: Children aged 11-18 years with a) mild TBI presenting to the Emergency Department (ED) (acute/subacute); and b) mild to severe TBI symptomatic ≥1 month post-injury (chronic). Outcome measures: A new questionaire about dizziness for kids "DizzyKids". Vestibular testing was performed using the Head Impulse test and ICS Impulse goggles, a novel diagnostic tool.
Results: Thirty children (21 males), aged 14.3 (SD+/-2.3) years were enrolled. True “vertiginous” symptoms were not associated with semicircular canal dysfunction. There was a 10% prevalence of vestibular dysfunction in both groups.
Conclusion: Vestibular dysfunction secondary to head trauma occurs in 10% of children with acute mild TBI and in those with chronic post-concussive symptoms. The DizzyKids Questionnaire and ICS Impulse goggles were useful and well tolerated in the pediatric population.