MARCH 25 — A decade ago, I attended a Pediatric Otorhinolaryngology Conference in Barcelona, Spain, where a presentation titled “Vertigo in Children: What’s the Latest, and Where Are We Heading?” caught my attention.
It was a revelation — an eye-opener to the fact that vertigo in children, particularly in Malaysia, is not commonly discussed or diagnosed.
Nonetheless, over the years, it has become increasingly evident that paediatric vertigo is often overlooked and under-reported, with the actual prevalence likely being much higher than previously thought.
Vertigo refers to a sensation of spinning, imbalance, or unsteadiness, typically accompanied by nausea, headaches, or abdominal discomfort.
Unlike adults, children may not describe their symptoms as “dizziness” but instead express discomfort by avoiding activities like riding a bicycle or playing on swings, becoming often irritable, or appearing clumsy.
Vertigo in children is associated with either a delay or dysfunction of the vestibular system, including its pathways and connections within the central nervous system.
Causes of paediatric vertigo include vestibular migraines, inner ear infections such as labyrinthitis, middle ear effusion, hearing loss, benign paroxysmal positional vertigo of childhood, and vestibular disorders associated with systemic neurological or genetic conditions.
While vertigo is commonly associated with older adults, its impact on children is often underestimated despite its significant effects on daily functioning, academic performance, and social development.
Why is paediatric vertigo under-recognised?
In contrast to the adult population, children often struggle to articulate their symptoms as they are still developing an understanding of their bodies and their surroundings.
Due to the neuroplasticity of the developing brain, children tend to tolerate vertigo symptoms better, often resulting in transient or self-limiting symptoms.
Moreover, children with vestibular dysfunction often experience faster recovery than adults, owing to the brain’s robust compensatory mechanisms that facilitate neural adaptation and balance restoration.
Left untreated, studies have shown that vestibular dysfunction in children can impair reading and learning tasks that require stable gaze function, resulting in long-term consequences, including poor academic performance, social difficulties, and reduced overall quality of life.
Children often struggle to articulate their symptoms as they are still developing an understanding of their bodies and their surroundings. — Picture by Sayuti Zainudin
What is less recognised is that even if a child learns to adapt, the long-term ramifications of vestibular dysfunction can be profound, impacting not only the child and their family but also their scholastic performance, social development, physical health, the healthcare system, educational resources, parental productivity, and even the broader economy.
It is worth noting that cultural factors may also contribute to the under-reporting of paediatric vertigo.
Across Asian societies, children are often expected to be resilient and endure challenges without complaint.
Frequent expressions of discomfort may be dismissed as attention-seeking behaviour, with parents sometimes facing criticism for perceived poor parenting.
In contrast, Western cultures tend to encourage children to openly communicate their symptoms, leading to earlier diagnosis, timely intervention, and an improved quality of life.
Bridging this gap through awareness campaigns and education is crucial in ensuring that vestibular disorders in children are recognised and managed appropriately.
The growing interest in paediatric vestibular disorders worldwide highlights the need for increased awareness, earlier diagnosis, and more effective intervention strategies.
By recognising the signs of vestibular dysfunction and addressing the cultural and clinical barriers to diagnosis, we can improve outcomes for children affected by these conditions.
It is time to shift the perception of vertigo as solely an adult concern and ensure that children receive the care and attention they need.
* Dr Jeyasakthy Saniasiaya is a lecturer and Consultant Paediatric Otorhinolaryngologist at the Faculty of Medicine, Universiti Malaya, and she is also the pioneer of Malaysia’s first Paediatric Vestibular and Balance Clinic.
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
