{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:48:19Z","timestamp":1791946099612,"version":"4.3.4"},"reference-count":58,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the relative prevalence of individual diagnoses in children and adolescents presenting with dizziness and\/or imbalance, and to assess the proportion of patients assigned multiple contributing diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed our internal database of all patients seen at our pediatric vestibular program between January 2012 and March 2019 to determine the incidence of common diagnoses and groups of diagnoses for patients ages 21 or younger.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One thousand twenty\u2010one patients were included with a mean age of 12.5\u2009\u00b1\u20094.9\u2009years (range: 9\u2009months\u201321\u2009years). Of this total, 624 patients were female and 397 were male. Common diagnoses included vestibular migraine (VM; 35.0%), benign paroxysmal positional vertigo (BPPV; 21.6%), primary dysautonomia (15.7%), anxiety disorder (13.5%), and persistent postural perceptual dizziness (PPPD; 11.2%). A high proportion of patients (44.4%) received multiple contributing diagnoses. VM was frequently diagnosed with BPPV or PPPD, and 22 patients were diagnosed with all three concurrently.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The causes of dizziness and imbalance in the pediatric population are diverse, and many patients have multiple diagnoses that are often interrelated. It is important that providers recognize that the causes of vestibular symptoms in children and adolescents may be multifactorial and may span across multiple specialties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E1308\u2013E1314, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29024","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T05:12:11Z","timestamp":1598591531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Multifactorial Characteristics of Pediatric Dizziness and Imbalance"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4137-8547","authenticated-orcid":false,"given":"Alicia","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."},{"name":"Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Lipson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."},{"name":"Tufts School of Medicine  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."},{"name":"Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Corcoran","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9656-5855","authenticated-orcid":false,"given":"Jacob R.","family":"Brodsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Enhancement Boston Children's Hospital  Boston Massachusetts U.S.A."},{"name":"Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819887375"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1598645"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(03)00136-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.04.001"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.02.009"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00025-X"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.01.012"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.01.003"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.06.015"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810393679"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-8994(03)00278-9"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.06.020"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/14992020802334358"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419845014"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001429"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0000000000000116"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413485658"},{"key":"e_1_2_6_21_1","unstructured":"Journal of Vestibular Research. International classification of vestibular disorders 2019. Available at:https:\/\/www.jvr-web.org\/ICVD.html. Accessed June 1 2020."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097878"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181f20673"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00022-4"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-017-0476-z"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2017.01.014"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2015.09.011"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2006.11.024"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001673"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818770618"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2014.08.012"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2017-001809"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-018-0535-0"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.2.170"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.06.040"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511410655"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200403000-00009"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13709"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000536"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2020.1723698"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489639"},{"key":"e_1_2_6_42_1","first-page":"809","article-title":"Symptoms of vertigo in general practice: a prospective study of diagnosis","volume":"52","author":"Hanley K","year":"2002","journal-title":"Br J Gen Pract"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319871234"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00749"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.3109\/10401239809147746"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-015-0547-z"},{"key":"e_1_2_6_47_1","first-page":"133","article-title":"Benign paroxysmal positional vertigo and migraine: analysis of 186 cases","volume":"10","author":"Faralli M","year":"2014","journal-title":"B\u2010Ent"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117000536"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556130408301211"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.5935\/0946-5448.20150011"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2006.01208.x"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2009.09.034"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2011.10.009"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-101207"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00025"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.5.554"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200407000-00022"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-012-0424-y"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2003.03005.x"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29024","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29024","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T00:49:58Z","timestamp":1693702198000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,18]]},"references-count":58,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/lary.29024"],"URL":"https:\/\/doi.org\/10.1002\/lary.29024","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,18]]},"assertion":[{"value":"2020-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}