Introduction: Proper development of postural control in children is connected with the maturation of the central nervous system, development of sensory organisation with appropriate use of proprioceptive, visual, vestibular information as well as reactions and postural strategy which allow the maintenance of balance in changeable environmental conditions. Developmental disturbances in this particular area is reflected in postural disfunctions and the assessment of these disfunctions and disturbances needs referring to normative values of the healthy population of children. Aim: Examination of postural control development in children aged 6–17 years. Material: 127 healthy children were tested (65 girls and 62 boys) aged 6–17 years. Method: Laryngological investigation, medical history interview, audiometry and tympanometry were conducted in all children. In the evaluation of postural control (mCTSIB-modified Clinical Test For The Sensory Interaction On Balance) a computer posturography system was used (Balance Master Neurocom). R esults: Further development of postural control was found in healthy children up to the age of 13 years of age. The development was not linear but showed transient characteristics with a faster development stage between the age of 6–7 and 8–9. Better postural control in girls, particularly the youngest, in comparison with boys was noticed. C onclusions: 1. The values of norm postural control in posturographic test mCTSIB in children aged 6–17 was established. In this test postural control development was completed in children before 13 year and it was not linear. 2. Due to gender differences it seems appropriate to use separate norms in order to evaluate the development of postural control in boys and girls.
Introduction: The ability to Reach quickly to changing external stimuli, to move the body quickly and precisely in any direction and to maintain the centre of gravity above the support base, all contribute to maintaining balance in dynamic conditions. The Limits of Stability Test (LOS) provides information on the state of dynamic equilibrium in a standing position. Aim : Assessment of dynamic postural control in developmental age. Material : 127 healthy children (65 girls and 62 boys) aged 6 – 17years. Methods: All children underwent LOS test (posturograph NeuroCom) with registration of reaction time (RT), movement velocity (MVL), directional control (DCL) , maximum excursion (MXE) and endpoint excursion (EPE). Results: At the age of 6-7 years, not fully developed jumping strategy and visual feedback mechanism in the control of movement were observed. All tested parameters were significantly worse in children aged 6 – 9 years. After this period, a significant improvement in TR and MVL was observed, with no significant changes in subsequent age groups while significant improvement in MXE up to 12 , EPE and DCL up to 13 years of age was noted. No significant gender differences were fund in the LOS test parameters. Conclusions: 1 The LOS test showed significantly lower dynamic balance development in children aged 6 – 7 years. 2 The study showed a significant improvement in all parameters of the LOS test up to 13 years of age, which supports the termination of the function at that time.
Introduction. Vertigo and dizziness in 50% of the children group are connected with ear media pathology as well as migraine and its equivalents. In the other cases, the causes of these disturbances may be similar to the ones in adults, however their frequency is significantly related to the age and sex of a child. Aim. The evaluation of the vestibular organ function in children with vertigo or balance disturbances, who were not diagnosed at children’s neurology department. Material and methods. 44 children (24 girls, 20 boys) aged 4-17 years (on average – 12,5 years). In all cases the patient’s history was taken and laryngological examination, hearing tests and electronystagmography (ENG) were performed. Results. In 42 children the symptoms were paroxysmal, with 54.5% of vertigo type. They were accompanied by: transient disequilibrium in 36.3% cases, in 40.9% - headaches, psychogenic disturbances in 15.9%, panic attacks in 9% cases. In 23 children (52.2%) the following ENG abnormalities were observed. In 33 (75%) children final or probable diagnosis was established. 25% of the cases were not diagnosed. Conclusions. Analysis of medical history, clinical picture supplemented by vestibular organ examinations allowed, in 75% of cases, to establish final or probable diagnosis for further observation. The work results prove the need of performing vestibular examination in children with vertigo, particularly of unclear clinic picture or incoherent results of diagnostic tests.
PL
Wstęp. Zawroty głowy u dzieci w około 50% są związane z patologią ucha środkowego oraz migreną i jej ekwiwalentami. W pozostałych przypadkach mogą być to przyczyny podobne jak u dorosłych, ale ich częstotliwość znacząco wiąże się z wiekiem i płcią dziecka. Cel pracy. Ocena funkcji narządu przedsionkowego u dzieci z zawrotami lub zaburzeniami równowagi, u których nie ustalono rozpoznania w oddziale neurologii dziecięcej. Materiał i metody. 44 dzieci (24 dziewczynki, 20 chłopców) w wieku 4-17 lat (średnio 12,5). U wszystkich przeprowadzono wywiad, badanie laryngologiczne oraz badanie elektronystagmograficzne (ENG). Wyniki. U 42 dzieci zawroty były napadowe, w tym w 59% o charakterze układowym. Towarzyszyły im przejściowe zaburzenia równowagi (36%), bóle głowy (41%), zaburzenia psychogenne (16%), napady lęku (9% przypadków). Odchylenia w ENG odnotowano ogółem u dwudziestu trojga dzieci (52%). U trzydziestu trojga (75%) badanych dzieci ustalono rozpoznanie ostateczne lub prawdopodobne. Stwierdzono różnicę w przyczynach zawrotów głowy w zależności od płci i wieku dzieci. W 25% przypadków nie udało się ustalić rozpoznania. Wnioski. Badania narządu przedsionkowego wykazały szereg nieprawidłowości o charakterze obwodowym i ośrodkowym u ponad połowy badanych dzieci z zawrotami głowy. Analiza wywiadu, obrazu klinicznego, szeregu konsultacji specjalistycznych, w tym prowadzącego neurologa dziecięcego, uzupełniona badaniami narządu przedsionkowego pozwoliła u 3/4 dzieci ustalić ostateczne lub prawdopodobne rozpoznanie.
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