Assessment of child neurology outpatients with headache, dizziness, and fainting

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Research Abstract from J Child Neurol. 2004 May;19(5):332-6.

Assessment of child neurology outpatients with headache, dizziness, and

fainting.

Emiroglu FN, Kurul S, Akay A, Miral S, Dirik E.

Department of Child and Adolescent Psychiatry, Dokuz Eylul University

Faculty of Medicine, Izmir, Turkey.

Neurologic symptoms such as headache, vertigo, dizziness, and fainting

can create a diagnostic problem in pediatric neurology practice because

they are also the most common presenting symptoms of psychiatric

disorders. Children, especially adolescents, who are often admitted with

such autonomic symptoms, are frequently misdiagnosed. In this study, we

aimed to investigate the psychiatric morbidity and comorbidity rate in

children and adolescents presenting with neurologic symptoms such as

headache, vertigo, and syncope. We investigated 31 children who

presented with these symptoms. All children were evaluated for their

medical history and had a physical and neurologic examination. We

attempted to rule out a possible organic etiology. All patients received

a complete laboratory examination (blood count, electroencephalography),

pediatric cardiology and otorhinolaryngology consultations, and a

caloric test. All patients were assessed according to Diagnostic and

Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. The

majority of the patients (93.5%) received a psychiatric diagnosis

according to the DSM-IV criteria. Most of these patients were

adolescents and female. Psychosocial stressors such as academic

problems, familial dysfunction, parental psychopathology, and child

sexual abuse were associated with somatic symptoms. The results of this

study demonstrated the importance of differential diagnosis and

psychiatric comorbidity in a pediatric neurologic outpatient population.

Treatment should be directed at biopsychosocial integrity, and a

multidisciplinary treatment approach should be applied.