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Prevalence of Vestibular and Balance Disorders in Children

O'Reilly, Robert C.*; Morlet, Thierry; Nicholas, Brian D.*; Josephson, Gary; Horlbeck, Drew; Lundy, Larry§; Mercado, Arnel

doi: 10.1097/MAO.0b013e3181f20673
Vestibular Disorders

Objective: Determine the prevalence of vestibular and balance disorders in children, rate of complaints of imbalance, and odds ratio of related diagnoses.

Patients and Methods: Retrospective review of pediatric health system during a 4-year period for International Classification of Diseases, 9th Revision, codes related to balance disorders. Identified records were searched for chief complaints related to balance and for codes of related otologic and neuro-otologic diagnoses.

Results: A total of 561,151 distinct patient encounters were found. Unspecified dizziness was diagnosed in 2,283 patients (0.4%). Also, 22% presented with balance complaints. Peripheral disorders were diagnosed in 159, and central disturbances were diagnosed in 109 (prevalence < 0.0002%). Cumulative prevalence of diagnoses related to balance was 0.45% (2,546/561,151). Of all patients, 5,793 (1.03%) had chief complaint related to balance, and 2,076 (35.84%) were also diagnosed with vestibular disorder. Moreover, 38% with peripheral disturbances and 21% with central disturbances had balance complaints. Odds ratio of syncope was 21× higher than the general pediatric population in patients with unspecified dizziness, and sensorineural hearing loss was 43 times higher in those with peripheral vestibular disorders. In patients with central disorders headache was 16× higher (p < 0.05).

Conclusion: The prevalence of balance disorders in children is low. Children diagnosed with these disorders typically do not present with chief complaint related to balance. Significant associations exist between sensorineural hearing loss, syncope, and headache in children diagnosed with balance disorders.

*Department of Otolaryngology and †Center for Pediatric Auditory and Speech Sciences, Alfred I. duPont Hospital for Children, Wilmington, Delaware; ‡Division of Pediatric Otolaryngology, Nemours Children's Clinic, Jacksonville, Florida; §Division of Pediatric Otolaryngology, Mayo Clinic, Florida; and ∥Department of Research, Alfred I. duPont Hospital for Children, Wilmington, Delaware, U.S.A.

Address correspondence and reprint requests to Robert C. O'Reilly, M.D., Division of Pediatric Otolaryngology, Alfred I. duPont Hospital for Children, PO Box 269, Wilmington, DE 19899, U.S.A.; E-mail:

© 2010 Otology & Neurotology, Inc.