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Comment from Dr. Mladenoff


This study indicates that prolonged symptoms of dizziness and/or balance issues in 90% of children with sports related concussion continue to have at least 1 positive clinical presentation. It is imperative that dynamic visual acuity  and balance tests be performed initially and repeatedly throughout  the management of care with or without the presence of clinical symptomatology.
Abstract:
Objective vestibular testing of children with dizziness and balance complaints following sports-related concussions
Guangwei Zhou, Jacob R Brodsky
Otolaryngology—Head and Neck Surgery 2015, 152 (6): 1133-9

OBJECTIVE: To conduct objective assessment of children with balance and vestibular complaints following sports-related concussions and identify the underlying deficits by analyzing laboratory test outcomes.

STUDY DESIGNS: Case series with chart review.

SETTING: Pediatric tertiary care facility.

SUBJECTS AND METHODS: Medical records were reviewed of 42 pediatric patients with balance and/or vestibular complaints following sports-related concussions who underwent comprehensive laboratory testing on their balance and vestibular function. Patients' characteristics were summarized and results analyzed.

RESULTS: More than 90% of the children with protracted dizziness or imbalance following sports-related concussion had at least 1 abnormal finding from the comprehensive balance and vestibular evaluation. The most frequent deficit was found in dynamic visual acuity test, followed by Sensory Organization Test and rotational test. Patient's balance problem associated with concussion seemed to be primarily instigated by vestibular dysfunction. Furthermore, semicircular canal dysfunction was involved more often than dysfunction of otolith organs. Yet, <10% of the children experienced a hearing loss following sports-related concussion.

CONCLUSIONS: Vestibular impairment is common among children with protracted dizziness or imbalance following sports-related concussion. Our study demonstrated that proper and thorough evaluation is imperative to identify these underlying deficits and laboratory tests were helpful in the diagnosis and recommendation of following rehabilitations.
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