Unilateral Vestibular Hypofunction in an Adolescent: Case Report and Literature Review

Abstract

Objective − The report presents a case of an adolescent girl with vertigo resulting from unilateral vestibular hypofunction, diagnosed after extensive pediatric and otorhinolaryngological evaluations.

Case Report − A seventeen-year-old female adolescent sought medical assistance at the pediatric emergency hospital service on several occasions within one year due to feelings of weakness and darkened vision occurring during abrupt standing, exposure to heat, and stress. Symptoms were initially attributed to school obligations, low blood pressure, and the menstrual cycle. After an episode that also involved a brief loss of consciousness, an extensive neurological evaluation was conducted, excluding epileptogenic causes. Subsequent diagnostic procedures included evoked visual potential tests, psychological assessments, laboratory blood tests, thyroid hormone assays, and Borrelia burgdorferi serology, all yielding normal results. Finally, otorhinolaryngological examinations were performed, including pure tone audiometry, tympanometry, video head impulse tests, videonystagmography, and vestibular evoked myogenic potential tests. These tests indicated symptoms arising from unilateral labyrinthine hypofunction of the inner ear. The patient underwent vestibular rehabilitation, resulting in symptom resolution and confirmed functional recovery.

Conclusion − Diagnosing vertigo in adolescence is challenging, as impaired balance can manifest as a symptom of various diseases. Presentation with atypical symptoms for peripherally caused balance disorders complicates diagnosis. Otorhinolaryngologists and audio-vestibular diagnosticians play pivotal roles in establishing accurate diagnoses.