儿童眩晕和头晕的病因、临床特征及预后：单中心18年回顾性分析

doi:10.12372/jcp.2024.24e0997

临床儿科杂志 ›› 2024, Vol. 42 ›› Issue (12): 1010-1014.doi: 10.12372/jcp.2024.24e0997

儿童眩晕和头晕的病因、临床特征及预后：单中心18年回顾性分析

曾祥丽¹^,⁴(), 郑俩荣²^,⁴, 戴永强³, 尹根蒂¹^,⁴, 黄绮玲¹^,⁴, 牟一坤⁵, 秦峰⁶, 张姝琪¹, 李凌伟¹, 黎志成¹^,⁴

1.中山大学附属第三医院耳鼻咽喉头颈外科，（广东广州 510630）
2.中山大学附属第三医院精神心理科，（广东广州 510630）
3.中山大学附属第三医院神经内科，（广东广州 510630）
4.中山大学附属第三医院眩晕耳鸣诊疗中心，（广东广州 510630）
5.中山大学附属第三医院儿科，（广东广州 510630）
6.中山大学附属第三医院神经外科（广东广州 510630）

收稿日期:2024-09-19 出版日期:2024-12-15 发布日期:2024-12-02
通讯作者: 曾祥丽电子信箱：zxiangl@mail.sysu.edu.cn

Causes, clinical features, and prognosis of dizziness and vertigo in children: an 18-year retrospective analysis at a single center

ZENG Xiangli¹^,⁴(), ZHENG Liangrong²^,⁴, DAI Yongqiang³, YIN Gendi¹^,⁴, HUANG Qiling¹^,⁴, MOU Yikun⁵, QIN Feng⁶, ZHANG Shuqi¹, LI Lingwei¹, LI Zhicheng¹^,⁴

1. Department of Otorhinolaryngology-Head and Neck Surgery, Guangzhou 510630, Guangdong, China
2. Department of Psychiatry, Guangzhou 510630, Guangdong, China
3. Department of Neurology, Guangdong, China
4. Vertigo and Tinnitus Diagnostic and Treatment Center, China
5. Department of Pediatrics, Guangdong, China
6. Department of Neurosurgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China

Received:2024-09-19 Published:2024-12-15 Online:2024-12-02

摘要/Abstract

摘要：

目的探讨儿童眩晕和头晕的病因及慢性眩晕和头晕的诊疗特点。方法回顾性分析眩晕中心2006年1月至2024年6月儿童眩晕和头晕患者的临床诊疗资料，分析其中慢性眩晕和头晕患儿的病因、诊疗经过及预后。结果纳入眩晕和头晕患儿208例，中位发病年龄9.8岁（14个月~18岁），女115例、男93例，其中慢性眩晕和头晕34例（16.3%），中位发病年龄为12.0（7.0~17.0）岁。34例慢性眩晕和头晕患儿按病因分类，其中精神心理性眩晕20例（58.9%），包括7例留守儿童，5例来自城市单亲家庭，3例来自父母离异后重组家庭，5例来自正常家庭，初始有前庭外周疾病；体位性低血压5例；特发性颅内高压3例；脑炎恢复期2例；创伤性应急障碍2例；其他2例。34例慢性眩晕和头晕患儿根据病因给予针对性治疗后，预后均良好。结论儿童慢性眩晕和头晕病因及预后与成人有较大区别，病因以精神心理性眩晕为主，预后良好。对于儿童眩晕和头晕的诊疗，多学科共同诊疗的模式至关重要。

关键词: 慢性眩晕头晕, 精神心理因素, 多学科诊疗, 儿童

Abstract:

Objective To explore the etiology of vertigo and dizziness in children and the characteristics of diagnosis and treatment of chronic vertigo and dizziness. Methods The clinical diagnosis and treatment data of children with vertigo and dizziness in the Vertigo Center from January 2006 to June 2024 were retrospectively analyzed. The etiology, treatment, and prognosis of chronic vertigo and dizziness in children were analyzed. Results A total of 208 children with vertigo and dizziness (115 girls and 93 boys) were included, and the median age of onset was 9.8 years (14 months to 18 years). Among them, 34 patients (16.3%) had chronic vertigo and dizziness, and the median age of onset was 12.0 (7.0-17.0) years. Among the 34 children with chronic vertigo and dizziness, 20 children (58.9%) had psychophysiological dizziness, 7 were left-behind children, 5 were from single-parent families in urban areas, 3 were from families reorganized after parental divorce, and 5 were from normal families with initial vestibular peripheral diseases. There were 5 cases of orthostatic hypotension, 3 cases of idiopathic intracranial hypertension, 2 cases of encephalitis convalescence, 2 cases of traumatic emergency disorder, and 2 cases of other causes. The prognosis of 34 patients with chronic vertigo and dizziness was good after targeted treatment according to the etiology. Conclusions The etiology and prognosis of chronic vertigo and dizziness in children are quite different from those in adults. The etiology is mainly psychogenic vertigo and the prognosis is good. A multidisciplinary approach is crucial for the diagnosis and treatment of vertigo and dizziness in children.

Key words: chronic vertigo and dizziness, psychological factor, multidisciplinary diagnosis and treatment, child

曾祥丽, 郑俩荣, 戴永强, 尹根蒂, 黄绮玲, 牟一坤, 秦峰, 张姝琪, 李凌伟, 黎志成. 儿童眩晕和头晕的病因、临床特征及预后：单中心18年回顾性分析[J]. 临床儿科杂志, 2024, 42(12): 1010-1014.

ZENG Xiangli, ZHENG Liangrong, DAI Yongqiang, YIN Gendi, HUANG Qiling, MOU Yikun, QIN Feng, ZHANG Shuqi, LI Lingwei, LI Zhicheng. Causes, clinical features, and prognosis of dizziness and vertigo in children: an 18-year retrospective analysis at a single center[J]. Journal of Clinical Pediatrics, 2024, 42(12): 1010-1014.

图/表 1

参考文献 23

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病因	例数	中位发病年龄（范围）/岁	备注
CBPV	31	6.5（1.3~11.0）
前庭性偏头痛	25	7.0（5.0~12.0）	6例共患慢性鼻窦炎
分泌性中耳炎	23	4.5（3.0~8.0）
梅尼埃病	22	9.5（5.0~18.0）
BPPV	23	10.0（6.0~18.0）
内耳畸形¹⁾	20	5.5（1.2~11.0）	出生听力筛查发现，成长过程中出现症状
突发性聋伴眩晕	15	8.5（6.0~18.0）
遗传性尿素循环障碍	2	7、13
前庭神经炎	13	8.0（6.0~18.0）
慢性头晕、眩晕	34	12.0（7.0~17.0）
精神心理性眩晕	20	9.0（7.0~16.0）	5例初始有外周前庭病变
体位性低血压	5	10.0（7.0~15.0）
特发性颅内高压	3	12.0（10.0~17.0）
脑炎恢复期	2	8、10
创伤性应激障碍	2	11、13	新冠疫情期间亲人故去
其他	2	7、8

儿童眩晕和头晕的病因、临床特征及预后：单中心18年回顾性分析

Causes, clinical features, and prognosis of dizziness and vertigo in children: an 18-year retrospective analysis at a single center

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