What is vertigo (dizziness)?

Vertigo can be either a sensation of spinning, like the dizzy feeling your child gets after the merry-go-round, or it can be a perception that the world around him is spinning or tilting.

Occasionally, a child can experience vertigo when congestion from a cold or an ear infection presses on his inner ear, which is part of the vestibular system that affects balance. But when a child experiences repeated or prolonged bouts of vertigo, it usually happens in conjunction with other illnesses or conditions.

Overall, vertigo is far less common in children than it is in adults.

Vertigo can be very distressing to a child and can affect children of all ages. Until a child is old enough to express his feelings of vertigo, a parent might notice when the child has a bout and seems clumsy or nauseous, or his eyes might dart back and forth. It is important to seek treatment for vertigo, as it can be a sign of a serious illness and can lead to injuries due to the disruption in balance and coordination.

Cause

Vertigo or dizziness can occur in children either with or without an eardrum problem.

An eardrum problem causes dizziness because the body’s sense of balance is located in the inner ear’s vestibular system. Most eardrum problems that cause vertigo are tied to minor illnesses that, once treated, can eliminate the vertigo.

But other systems in the body can cause vertigo as well. Depending on the disorder causing the symptoms, the bouts of dizziness can be more persistent. In these cases, a change in head position is often a trigger, and your child may experience other symptoms, like nausea and darting eye movements (nystagmus), as well.

The many possible causes of vertigo include:

• Middle-ear infection or middle-ear “effusion,” in which a thick fluid builds up behind the eardrum, but no infection is present; in either case, your child’s sense of balance, located in the inner ear, is temporarily disrupted from the fluid pressing on the inner ear
• Inner ear infections, including labyrinthitis and vestibular neuritis
• Concussion or other head trauma
• Small bone-like particle(s) floating in the inner ear fluid, residual from a concussion or an infection
• Migraines, considered a vascular disorder because blood vessels in the brain dilate and produce the throbbing headache; a “motion sickness,” or intolerance, is often the form of vertigo that goes along with migraine
• Benign paroxysmal positional vertigo (BPPV), which involves sudden attacks of dizziness and often rapid eye movements; in many cases, this disorder appears to be related to an early sign of chronic migraines  
• Seizures
• Low blood pressure
• Autoimmune disorders, such as multiple sclerosis, Type 1 diabetes, and juvenile arthritis
• Visual dysfunctions, such an excessive difference in prescription between the eyes or a congenital eye movement disorder
• A brain tumor
• Meniere’s disease
• Aspirin and other nonsteroidal anti-inflammatory drugs

Symptoms

Symptoms of vertigo can vary from child to child and depend on the cause and severity of the vertigo. Some common symptoms include:

• Child complaining of a dizziness, which might feel like a post-merry-go-round sensation, a perception the room is spinning or tilting, or a “motion sickness,” like your child is rocking on a boat and can’t tolerate motion
• Dizziness triggered by a change in head position — either your child turns his head or stands up from a lying down position. This vertigo usually lasts only seconds or minutes
• Unusual awkwardness, clumsiness or poor balance
• Complaint of ear ringing (tinnitus), ear pain or ear stuffiness
• Hearing loss
• Fever of more than 100 degrees
• Migraine
• Confusion
• Collapse or blacking-out
• Nausea
• Vomiting
• Sweating
• Pale complexion
• Eyes darting back and forth (nystagmus)
• The desire to lie still
• Loss of fine or gross motor skills
• Delayed motor milestones, such as a slowness to hold his head upright, stand or walk