Approach to the child with true vertigo

TM: tympanic membrane; PCP: phencyclidine; ICP: intracranial pressure.
* Emergency imaging of choice for trauma patients is computed tomography of the head with temporal bone windows. Magnetic resonance imaging of the brain is preferred when brain tumor or stroke is suspected if it can be rapidly and safely performed.
¶ Patients with signs of meningitis or encephalitis and focal neurologic deficits or concern for increased intracranial pressure also warrant neuroimaging.
Δ For descriptions of physical examination testing of vestibular function, including the head impulse test, refer to UpToDate topics on vertigo in children. Some patients may require specialized testing by an otologist.
◊ Medications that may cause hearing loss with vertigo include aminoglycosides, furosemide, minocycline, and salicylates.