Dizziness and vertigo in children under 16 years - NICE guidance - suspected neurological conditions - recognition and referral

Dizziness and vertigo in children

Summary points from NICE guidance relating to dizziness and vertigo in children are:

Dizziness with no accompanying symptoms or signs

• be aware that isolated dizziness in children is unlikely to be a symptom of a brain tumour if there are no accompanying symptoms or signs
  
  
• be aware that dizziness in children is often a symptom of migraine and may be the predominant feature

Dizziness in older children

• be aware that in older children (usually aged over 8 years), dizziness related to change in posture is often caused by postural hypotension

Dizziness caused by middle ear infection or effusion

• in children with dizziness, examine the ears for any signs of infection, inflammation or eardrum perforation

Recurrent dizziness

For children with recurrent episodes of dizziness:

• consider referring for cardiological assessment if there are any factors that might suggest a cardiac cause, such as blackouts (transient loss of consciousness), a family history of cardiomyopathy or unexplained sudden death, or palpitations
  
  
• if there are episodes of dizziness with a fixed symptom pattern, be alert to the possibility of epilepsy with assessment/management in consideration of this possible diagnosis

Reference:

• NICE (May 2019). Suspected neurological conditions: recognition and referral