Dizziness: Mum, everything is spinning!
Dizziness is relatively common in children and adolescents. Although the symptom can be frightening, the cause is usually harmless. Nevertheless, medical clarification is important.
The most important facts in brief:
How common is dizziness in children and adolescents?
Experts estimate that five to 25 per cent of children and adolescents are affected by dizziness every year - older children and adolescents more frequently than younger children.
What are the most common types of dizziness?
The most common types of vertigo in children and adolescents are recurrent childhood vertigo, vertigo migraine, psychosomatic vertigo, circulatory vertigo, travel sickness and vertigo.
When should dizziness be checked by a doctor?
Dizziness that occurs more than once or is severe, as well as balance disorders, should be clarified by a doctor. In this way, serious causes can be ruled out and suitable treatment can be initiated.
How can dizziness be treated?
Treatment depends on the cause of the dizziness. In the case of recurrent childhood vertigo and vertigo migraine, behavioural changes and, if necessary, medication can often help. Behavioural therapy can be helpful for psychosomatic dizziness.
Sophia has been suffering from vertigo attacks for two years. In the beginning, they only occurred every few weeks, but for the past six months they have been occurring up to twice a week. The 14-year-old then has the feeling that everything revolves around her. She finds loud noises disturbing, she feels nauseous and has an unpleasant headache. Sometimes she has to be picked up from school and put to bed at home. Finally, she goes to the GP with her mother, who refers her to an outpatient dizziness clinic. There she was diagnosed with vertigo migraine.
«Dizziness in childhood and adolescence is more common than you might think,» says Nicolas Gürtler, Head of Paediatric Otorhinolaryngology at the University Children's Hospital Basel UKBB. Experts estimate that dizziness attacks occur in 5 to 25 per cent of children and adolescents every year. These usually last from a few minutes to several hours, with some children experiencing permanent dizziness.
Dizziness can often be caused by a dysregulation of the circulation. The children have a groggy or woozy feeling.
Adolescents seem to be most frequently affected. Dizziness is observed less frequently in pre-school children - although they are not yet able to report the symptoms as accurately. «The different forms of dizziness are equally common in boys and girls,» explains Doreen Huppert, Head of the Outpatient Clinic of the German Dizziness and Balance Centre DSGZ at the Ludwig Maximilian University Hospital LMU Munich. «Only vertigo migraines are slightly more common in girls.»
Many possible causes
The causes of dizziness can be very different. «Dizziness is not a disease, but a symptom that can have many causes,» explains Huppert. «The reassuring thing is that dizziness often has an unproblematic course and can be treated well. What's more, it is not usually associated with other impairments, such as attention or memory.» However, dizziness that occurs more than once or is more pronounced should always be taken seriously and clarified by a doctor. The same applies if a child has balance problems, such as swaying when walking. «A medical examination can rule out a serious cause or treat it if necessary,» says Gürtler. «And suitable treatment measures can be initiated.»
The first point of contact is the paediatrician. «Depending on the suspected cause, they can refer you to an ear, nose and throat specialist, a neurologist or an outpatient dizziness centre for children,» says Gürtler. However, such specialised centres are few and far between: In Switzerland at the UKBB in Basel and at the Hôpitaux Universitaires Genève HUG, in Germany at the LMU Munich.
Dizziness can often be caused by a dysregulation of the circulation. The children have a groggy or woozy feeling or their eyes go black for a moment. This is triggered by a sudden drop in blood pressure, for example when standing up from a lying or sitting position - especially in children who are growing rapidly. Too little fluid, low blood sugar or too little exercise can also favour circulatory dizziness. Other harmless causes of dizziness are motion sickness, where the rocking of vehicles triggers dizziness, and vertigo, where looking down from a height leads to dizziness.
Everything sways or turns
«With true vertigo, on the other hand, those affected have the feeling that everything is spinning around them or that their surroundings are swaying back and forth,» explains Gürtler. «Common causes in children and adolescents are recurrent childhood vertigo and vertigo migraine.» The former mainly occurs between the ages of two and twelve. The children have sudden, rather short dizziness attacks, during which they stand or walk unsteadily and their eyes tremble. They may also experience nausea and vomiting. In some children, the symptoms disappear by themselves over time, while in others they develop into dizziness migraines. «This can already occur in very young children, but is often only discovered later,» says the ENT specialist. «In this case, the sudden dizziness attacks are associated with headaches, nausea and increased sensitivity to light and sound.»
For harmless forms of dizziness, simple tricks that parents and children can implement themselves often help.
Psychosomatic dizziness is also relatively common, where psychological causes such as severe mental stress or anxiety are behind the feeling of dizziness. «This often results in a vicious circle, because those affected are afraid of the next vertigo attack and focus their attention heavily on their sense of balance. This in turn intensifies the dizziness,» says Huppert.
Dizziness can also have physical causes - often in the inner ear, where the organ of balance is located, or in the brain. «Common causes are concussions and ear infections,» reports Athanasia Korda, Senior Physician at the Vertigo Centre at Inselspital Bern. Congenital changes to the inner ear, inflammation of the vestibular nerve or a tumour in the brain can also lead to vertigo. «In the case of a tumour, the prognosis for vertigo is usually not so favourable,» says Huppert. However, this is a rare cause of dizziness in children.
Parents and children can do this themselves if they suffer from dizziness:
- rn
- Even a consultation with a doctor can be reassuring for parents and children.
- is because dizzy spells are usually harmless and easily treatable.
- Parents can reassure their child and make it clear that the dizziness is not dangerous. They can also encourage them not to avoid situations out of fear of dizziness.
- In the case of dizziness caused by circulatory problems, the child should lie down, put their legs up and drink a glass of water. To prevent this, sufficient exercise and drinking, alternating showers and standing up slowly can be helpful.
- Looking out of the window in the direction of travel, having enough fresh air and not eating heavy meals often helps to prevent travel sickness. You may be able to take medication for travel sickness.
This
rn
rn
rn
rn
Examinations less stressful
The examinations at the doctor's are generally not very stressful. «The most important part is a detailed discussion about your medical history,» says Gürtler. «This includes, for example, how long and how often the dizziness has been occurring, what makes the dizziness better or worse and whether there are any other symptoms.»
This is followed by neurological and instrumental examinations to check whether the sense of balance and eye movements are intact. «If everything is in order here, a serious cause of the dizziness is unlikely,» says Doreen Huppert. For example, the children should fixate on a point while resting or turning on a swivel chair or stand on the spot with their eyes open or closed. Depending on the suspected cause, brain imaging examinations, a hearing test or psychological tests can also be carried out.
A healthy lifestyle often helps
How dizziness is treated depends primarily on its cause. In the case of harmless forms of dizziness, simple tricks that parents and children can implement themselves often help. If the dizziness has a physical cause, this is treated as far as possible.
A healthy lifestyle can be helpful for recurrent childhood vertigo and vertigo migraines. «This includes getting enough sleep, reducing stress, maintaining a regular daily routine, doing enough sport and drinking enough,» says Huppert. «All of this often makes a significant contribution to the dizziness decreasing or disappearing completely.» A dizziness diary can help to recognise the triggers of dizziness and take targeted countermeasures.
«If behavioural changes are not enough or the symptoms are so severe that they significantly affect the child's everyday life, medication should also be considered,» says Gürtler. «Recurrent childhood dizziness usually does not require long-term medication. Beta blockers, anti-epileptic drugs and calcium channel blockers have proven to be helpful for vertigo migraines.»
Pay less attention to dizziness
If the dizziness has psychological causes, behavioural therapy is often helpful. «Just the information that constantly observing the dizziness makes it worse is helpful for many people,» says Huppert. «In therapy, patients also learn how to distract themselves and pay less attention to the dizziness.» If the dizziness is related to anxiety, depression or stress at school, these can also be treated with psychotherapy.
Sophia has made many changes since her diagnosis: she now makes sure she gets enough sleep and avoids stress. Her parents support her in drinking plenty of fluids during the day, eating a healthy diet and maintaining a regular daily routine. She does a relaxation exercise every day and plays volleyball twice a week at the club. She also takes 300 milligrams of magnesium twice a day. All this pays off after a while: After about two months, the dizziness attacks only occur very rarely.
