Balance disorders in children after cranial-cerebral trauma with total damage to the vestibular apparatus
More details
Hide details
Outpatient Healthcare Clinic Medyk in Młynary, Poland
Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
Piotr M. Kowalski   

Janowicza 32/13, 10-690 Olsztyn, Poland. Tel.: +48 508 110 789.
Submission date: 2014-05-26
Acceptance date: 2014-07-16
Online publication date: 2014-08-15
Publication date: 2020-04-06
Pol. Ann. Med. 2014;21(2):139–142
Posttraumatic brain injury is one of the most common causes of disability and death among children. Every 2nd child in Poland requires medical intervention after suffering from cranial-cerebral trauma, and every 10th is being admitted to hospital for the same reason. In children, only a very small fraction of this type of traumas leads to temporal bone fracture with complete vestibular apparatus damage, followed by disturbances in balance and dizziness.

The aim of this paper is to provide with easily accessible and unsophisticated therapy methods applied in children with total damage to vestibular system.

Case study:
This paper presents a case of a 6-year-old boy who has suffered from cranialcerebral trauma with a total damage to the vestibular system, with accompanying symptoms of dizziness, impaired balance, and unilateral hearing loss. Patient was implemented in rehabilitation based on vestibular physiotherapy, visual- and mobility-coordination exercises, balance exercises and adequate psychotherapy. Improvement relied on simple and child-friendly methods.

Results and discussion:
Diminution of dizziness and balance deficit in vestibular apparatus damage depends upon alignment of bioelectrical activity between two vestibuli. Onset of such process begins few hours after the vestibular damage has occurred and is based on inhibition of excessive reactions from unaffected vestibulum, as well as stimulation of the one with defect. It is being regulated in CNS on the basis of positive and negative feedbacks.

Easily accessible and friendly methods of rehabilitation significantly shorten the time of almost full recovery in children with vestibular system damage; moreover continuous stimulation of CNS through repetition of mobility exercises shortens recovery time and has a significant value in development of correct image of spatial information.

None declared.
Mazur J. Wypadki, urazy i zatrucia u dzieci i młodzieży w Polsce. Zdrowie Naszych Dzieci. Warszawa: Instytut Matki i Dziecka; 2001 [in Polish].
Kowalski IM. Modern neurobiology and progress in rehabilitation. Adv Rehabil. 2005;1:121–125.
Janczewski G. Zawroty głowy (vertigo). Kompendium lekarza praktyka. Warszawa: Solvay Pharma; 1995 [in Polish].
Pośpiech L. Vestibular rehabilitation of vertigo and dizziness in clinical practice. Otorynolaryngologia. 2002;1:21–26 [in Polish].
Dick MR. The rationale and technique of head exercises in the treatment of vertigo. Acta Otorhinolaryngol. 1979;33:370–384.
Briand C, Boussens J, Voisin HP. La rééducation des handicaps vestibulaires. Rev Laryngol Otol Rhinol. 1974;95:631–639.
Voisin HP, Boussens J. Reeducation de lequilibration. Otol Rhinol. 1977;98:443–447.
Cohen H. Vestibular rehabilitation reduces functoinal disability. Otolaryngol Head Neck Surg. 1992;107:638–643.
Fujino A, Tokumasu K, Yosio S. Vestibular trainning for bening paroxysmal positional vertigo. Its efficacy in comparison with anti-vertigo drugs. Arch Otoraryngol Head and Nech Surg. 1994;120:497–504.
Horak FB, Jones-Rycewicz C, Black FO, Shumway-Cook A. Effects of vestibular rehabilitation on dizzines and imbalance. Otolaryngol Head Neck Surg. 1992;106:175.
Norre ME. Reliability of examination data in the diagnosis of benign paroxysmal positional vertigo. Am J Otol. 1995;16:806–810.
Odkvist J, Odkvist LN. Physiotherapy vertigo. Acta Otolaryngol. 1988;455:74–76.
Telian SA, Shepard NT. Update of vestibular rehabilitation therapy. Otolaryngol Clin North Am. 1996;29:359–371.
Kiebzak W, Kowalski IM, Domagalska M, et al. Assessment of visual perception in adolescents with a history of central coordination disorder in early life – 15-year follow-up study. Arch Med Sci. 2012;8:879–885.
Norre ME, De Weerdt W. Treatment of vertigo based on habituation. Technique and results of habituation trainning. Laryngol Otol. 1980;94:971–977.
Pośpiech L. Rehabilitacja następstw uszkodzenia narządów przedsionkowych. Janczewski G, Latkowski B, eds. Otoneurologia. vol. 2. Warszawa: Bel Copr. Scient.; 1998:503–514.