Mareo y vértigo ortostático, funcional y cinetosis
Resumen Introducción: el mareo en los niños ha recibido poca atención en la literatura médica, a pesar de su elevada prevalencia. Comprende un conjunto de patologías muy frecuentes y poco conocidas como el vértigo ortostático, el vértigo funcional y la cinetosis. El objetivo de este artículo ha consistido en presentar una revisión de la literatura sobre estos procesos. Materiales y Métodos: se realizó una revisión narrativa sobre el vértigo ortostático, el vértigo funcional y la cinetosis, mediante la selección de los artículos que consideramos más importantes, entre 2000 y 2023 en Pubmed, Scielo y Cochrane. Resultados: se presentan los artículos que, a nuestro criterio, mejor definen los procesos que se describen. Discusión: el mareo ortostático es el que aparece al incorporarse, de decúbito a sedestación, o de sedestación a bipedestación. El mareo funcional, conocido actualmente como mareo perceptual postural persistente, es un trastorno crónico, en el que los pacientes experimentan síntomas de mareo, y que se exacerba en bipedestación, el movimiento y/o la exposición a estímulos visuales complejos. La cinetosis es una respuesta fisiológica normal, ante una percepción inusual de movimiento; ya sea durante un movimiento real o en su ausencia; denominándose trastorno cuando la sintomatología es significativa. Todas las patologías estudiadas presentan unos criterios establecidos por la Sociedad Bárány. El tratamiento es personalizado dependiendo del perfil de cada paciente. Conclusiones: dada la variedad de causas de mareo en la infancia, es importante conocer los criterios diagnósticos y terapéuticos más adecuados para mejorar la calidad de vida de nuestros pacientes.
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Lipson S, Wang A, Corcoran M, Zhou G, Brodsky JR. Severe motion sickness in infants and children. Eur J Paediatr Neurol. 2020;28:176-9. https://doi.org/10.1016/j.ejpn.2020.06.010
Kim HA, Bisdorff A, Bronstein AM, Lempert T, Rossi-Izquierdo M, Staab JP, et al. Hemodynamic orthostatic dizziness/vertigo: Diagnostic criterio: : Consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2019;29(2-3):45-56. https://doi.org/10.3233/ves-190655
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. https://doi.org/10.3233/ves-2009-0343
Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21(2):69-72. https://doi.org/10.1007/s10286-011-0119-5
Stewart JM. Common syndromes of orthostatic intolerance. Pediatrics. 2013;131(5):968-80.
Novak P. Assessment of sympathetic index from the Valsalva maneuver. Neurology. 2011;76(23):2010-6. https://doi.org/10.1212/wnl.0b013e31821e5563
Zhang J, Zhu Q, Shen J, Chen J, Jin Y, Zhang Q, et al. Etiological classification and management of dizziness in children: A systematic review and meta-analysis. Front Neurol. 2023;14:1125488. https://doi.org/10.3389/fneur.2023.1125488
Lee H, Kim HA. Diagnostic approach of orthostatic dizziness/vertigo. Annals of Clinical Neurophysiology. 2020;22(2):75-81. https://doi.org/10.14253/acn.2020.22.2.75
Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017;27(4):191-208. https://doi.org/10.3233/ves-170622
Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. 2013. https://doi.org/10.1590/s2317-17822013000200017
Strupp M, Kim JS, Murofushi T, Straumann D, Jen JC, Rosengren SM, et al. Bilateral vestibulopathy: Diagnostic criteria Consensus document of the Classification Committee of the Bárány Society. J Vestib Res. 2017;27(4):177-89. https://doi.org/10.3233/ves-170619
Gerschlager W, Brown P. Orthostatic tremor - a review. Handb Clin Neurol. 2011;100:457-62. https://doi.org/10.1016/b978-0-444-52014-2.00035-5
Pappas DG, Jr. Autonomic related vertigo. Laryngoscope. 2003;113(10):1658-71. https://doi.org/10.1097/00005537-200310000-00005
Lanier JB, Mote MB, Clay EC. Evaluation and management of orthostatic hypotension. Am Fam Physician. 2011;84(5):527-36. PMID: 21888303
Pilcher TA, Saarel EV. A teenage fainter (dizziness, syncope, postural orthostatic tachycardia syndrome). Pediatr Clin North Am. 2014;61(1):29-43. https://doi.org/10.1016/j.pcl.2013.09.009
Strupp M, Brandt T, Dieterich M. Functional Dizziness and Vertigo. In: Strupp M, Brandt T, Dieterich M, editors. Vertigo and Dizziness: Common Complaints. Cham: Springer International Publishing; 2023. p. 301-20. https://doi.org/10.1007/978-0-85729-591-0
Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015;33(3):541-50, vii. https://doi.org/10.1016/j.ncl.2015.04.010
Dieterich M, Staab JP. Functional dizziness: from phobic postural vertigo and chronic subjective dizziness to persistent postural-perceptual dizziness. Curr Opin Neurol. 2017;30(1):107-13. https://doi.org/10.1097/wco.0000000000000417
Steensnaes MH, Knapstad MK, Goplen FK, Berge JE. Persistent Postural-Perceptual Dizziness (PPPD) and quality of life: a cross-sectional study. Eur Arch Otorhinolaryngol. 2023. https://doi.org/10.1007/s00405-023-08040-7
Wang A, Zhou G, Lipson S, Kawai K, Corcoran M, Brodsky JR. Multifactorial Characteristics of Pediatric Dizziness and Imbalance. Laryngoscope. 2021;131(4):E1308-e14. https://doi.org/10.1002/lary.29024
Wang A, Fleischman KM, Kawai K, Corcoran M, Brodsky JR. Persistent Postural-Perceptual Dizziness in Children and Adolescents. Otol Neurotol. 2021;42(8):e1093-e100. https://doi.org/10.1097/mao.0000000000003212
Kelly EA, Janky KL, Patterson JN. The Dizzy Child. Otolaryngol Clin North Am. 2021;54(5):973-87. https://doi.org/10.1016/j.otc.2021.06.002
Knight B, Bermudez F, Shermetaro C. Persistent Postural-Perceptual Dizziness. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC.; 2023. PMID: 35201726
Rossi M, Franco V. (2023). P.P.P.D. En ORL Guide. ISBN: 978-84-09-51490-8.
Staab JP, Ruckenstein MJ. Which comes first? Psychogenic dizziness versus otogenic anxiety. Laryngoscope. 2003;113(10):1714-8. https://doi.org/10.1097/00005537-200310000-00010
Popkirov S, Staab JP, Stone J. Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness. Pract Neurol 2018;18:5–13. https://doi.org/10.1136/practneurol-2017-001809
Staab JP, Ruckenstein MJ. Expanding the differential diagnosis of chronic dizziness. Arch Otolaryngol Head Neck Surg. 2007;133(2):170-6. https://doi.org/10.1001/archotol.133.2.170
Nada EH, Ibraheem OA, Hassaan MR. Vestibular Rehabilitation Therapy Outcomes in Patients With Persistent Postural-Perceptual Dizziness. Ann Otol Rhinol Laryngol. 2019;128(4):323-9. https://doi.org/10.1177/0003489418823017
Marambio G J, Segui V G, Cortés F I, Breinbauer K H. Mareo postural perceptual persistente: La causa más frecuente de mareo crónico es fácil de tratar. Revista de otorrinolaringología y cirugía de cabeza y cuello. 2019;79:323-8. http://dx.doi.org/10.4067/S0718-48162019000300323
Popkirov S, Stone J, Holle-Lee D. Treatment of Persistent Postural-Perceptual Dizziness (PPPD) and Related Disorders. Curr Treat Options Neurol. 2018 Oct 13;20(12):50. PMID: 30315375 https://doi.org/10.1007/s11940-018-0535-0
Keshavarz B, Golding JF. Motion sickness: current concepts and management. Curr Opin Neurol. 2022;35(1):107-12. https://doi.org/10.1097/wco.0000000000001018
Koch A, Cascorbi I, Westhofen M, Dafotakis M, Klapa S, Kuhtz-Buschbeck JP. The Neurophysiology and Treatment of Motion Sickness. Dtsch Arztebl Int. 2018;115(41):687-96. https://doi.org/10.3238/arztebl.2018.0687
Schmäl F. Neuronal mechanisms and the treatment of motion sickness. Pharmacology. 2013;91(3-4):229-41. https://doi.org/10.1159/000350185
Cha YH, Golding JF, Keshavarz B, Furman J, Kim JS, Lopez-Escamez JA, et al. Motion sickness diagnostic criteria: Consensus Document of the Classification Committee of the Bárány Society. J Vestib Res. 2021;31(5):327-44. https://doi.org/10.3233/ves-200005
Paillard AC, Quarck G, Paolino F, Denise P, Paolino M, Golding JF, et al. Motion sickness susceptibility in healthy subjects and vestibular patients: effects of gender, age and trait-anxiety. J Vestib Res. 2013;23(4-5):203-9. https://doi.org/10.3233/ves-130501
Leung AK, Hon KL. Motion sickness: an overview. Drugs Context. 2019;8. https://doi.org/10.7573/dic.2019-9-4
Shupak A, Gordon CR. Motion sickness: advances in pathogenesis, prediction, prevention, and treatment. Aviat Space Environ Med. 2006;77(12):1213-23. PMID: 17183916
Brainard A, Gresham C. Prevention and treatment of motion sickness. Am Fam Physician. 2014;90(1):41-6. PMID: 25077501
Chu H, Li MH, Juan SH, Chiou WY. Effects of transcutaneous electrical nerve stimulation on motion sickness induced by rotary chair: a crossover study. J Altern Complement Med. 2012;18(5):494-500. https://doi.org/10.1089/acm.2011.0366
Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009(2):Cd003281. https://doi.org/10.1002/14651858.cd003281.pub3
Cha YH, Deblieck C, Wu AD. Double-Blind Sham-Controlled Crossover Trial of Repetitive Transcranial Magnetic Stimulation for Mal de Debarquement Syndrome. Otol Neurotol. 2016;37(6):805-12. https://doi.org/10.1097/mao.0000000000001045
Kim HA, Bisdorff A, Bronstein AM, Lempert T, Rossi-Izquierdo M, Staab JP, et al. Hemodynamic orthostatic dizziness/vertigo: Diagnostic criterio: : Consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2019;29(2-3):45-56. https://doi.org/10.3233/ves-190655
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. https://doi.org/10.3233/ves-2009-0343
Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21(2):69-72. https://doi.org/10.1007/s10286-011-0119-5
Stewart JM. Common syndromes of orthostatic intolerance. Pediatrics. 2013;131(5):968-80.
Novak P. Assessment of sympathetic index from the Valsalva maneuver. Neurology. 2011;76(23):2010-6. https://doi.org/10.1212/wnl.0b013e31821e5563
Zhang J, Zhu Q, Shen J, Chen J, Jin Y, Zhang Q, et al. Etiological classification and management of dizziness in children: A systematic review and meta-analysis. Front Neurol. 2023;14:1125488. https://doi.org/10.3389/fneur.2023.1125488
Lee H, Kim HA. Diagnostic approach of orthostatic dizziness/vertigo. Annals of Clinical Neurophysiology. 2020;22(2):75-81. https://doi.org/10.14253/acn.2020.22.2.75
Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017;27(4):191-208. https://doi.org/10.3233/ves-170622
Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. 2013. https://doi.org/10.1590/s2317-17822013000200017
Strupp M, Kim JS, Murofushi T, Straumann D, Jen JC, Rosengren SM, et al. Bilateral vestibulopathy: Diagnostic criteria Consensus document of the Classification Committee of the Bárány Society. J Vestib Res. 2017;27(4):177-89. https://doi.org/10.3233/ves-170619
Gerschlager W, Brown P. Orthostatic tremor - a review. Handb Clin Neurol. 2011;100:457-62. https://doi.org/10.1016/b978-0-444-52014-2.00035-5
Pappas DG, Jr. Autonomic related vertigo. Laryngoscope. 2003;113(10):1658-71. https://doi.org/10.1097/00005537-200310000-00005
Lanier JB, Mote MB, Clay EC. Evaluation and management of orthostatic hypotension. Am Fam Physician. 2011;84(5):527-36. PMID: 21888303
Pilcher TA, Saarel EV. A teenage fainter (dizziness, syncope, postural orthostatic tachycardia syndrome). Pediatr Clin North Am. 2014;61(1):29-43. https://doi.org/10.1016/j.pcl.2013.09.009
Strupp M, Brandt T, Dieterich M. Functional Dizziness and Vertigo. In: Strupp M, Brandt T, Dieterich M, editors. Vertigo and Dizziness: Common Complaints. Cham: Springer International Publishing; 2023. p. 301-20. https://doi.org/10.1007/978-0-85729-591-0
Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015;33(3):541-50, vii. https://doi.org/10.1016/j.ncl.2015.04.010
Dieterich M, Staab JP. Functional dizziness: from phobic postural vertigo and chronic subjective dizziness to persistent postural-perceptual dizziness. Curr Opin Neurol. 2017;30(1):107-13. https://doi.org/10.1097/wco.0000000000000417
Steensnaes MH, Knapstad MK, Goplen FK, Berge JE. Persistent Postural-Perceptual Dizziness (PPPD) and quality of life: a cross-sectional study. Eur Arch Otorhinolaryngol. 2023. https://doi.org/10.1007/s00405-023-08040-7
Wang A, Zhou G, Lipson S, Kawai K, Corcoran M, Brodsky JR. Multifactorial Characteristics of Pediatric Dizziness and Imbalance. Laryngoscope. 2021;131(4):E1308-e14. https://doi.org/10.1002/lary.29024
Wang A, Fleischman KM, Kawai K, Corcoran M, Brodsky JR. Persistent Postural-Perceptual Dizziness in Children and Adolescents. Otol Neurotol. 2021;42(8):e1093-e100. https://doi.org/10.1097/mao.0000000000003212
Kelly EA, Janky KL, Patterson JN. The Dizzy Child. Otolaryngol Clin North Am. 2021;54(5):973-87. https://doi.org/10.1016/j.otc.2021.06.002
Knight B, Bermudez F, Shermetaro C. Persistent Postural-Perceptual Dizziness. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC.; 2023. PMID: 35201726
Rossi M, Franco V. (2023). P.P.P.D. En ORL Guide. ISBN: 978-84-09-51490-8.
Staab JP, Ruckenstein MJ. Which comes first? Psychogenic dizziness versus otogenic anxiety. Laryngoscope. 2003;113(10):1714-8. https://doi.org/10.1097/00005537-200310000-00010
Popkirov S, Staab JP, Stone J. Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness. Pract Neurol 2018;18:5–13. https://doi.org/10.1136/practneurol-2017-001809
Staab JP, Ruckenstein MJ. Expanding the differential diagnosis of chronic dizziness. Arch Otolaryngol Head Neck Surg. 2007;133(2):170-6. https://doi.org/10.1001/archotol.133.2.170
Nada EH, Ibraheem OA, Hassaan MR. Vestibular Rehabilitation Therapy Outcomes in Patients With Persistent Postural-Perceptual Dizziness. Ann Otol Rhinol Laryngol. 2019;128(4):323-9. https://doi.org/10.1177/0003489418823017
Marambio G J, Segui V G, Cortés F I, Breinbauer K H. Mareo postural perceptual persistente: La causa más frecuente de mareo crónico es fácil de tratar. Revista de otorrinolaringología y cirugía de cabeza y cuello. 2019;79:323-8. http://dx.doi.org/10.4067/S0718-48162019000300323
Popkirov S, Stone J, Holle-Lee D. Treatment of Persistent Postural-Perceptual Dizziness (PPPD) and Related Disorders. Curr Treat Options Neurol. 2018 Oct 13;20(12):50. PMID: 30315375 https://doi.org/10.1007/s11940-018-0535-0
Keshavarz B, Golding JF. Motion sickness: current concepts and management. Curr Opin Neurol. 2022;35(1):107-12. https://doi.org/10.1097/wco.0000000000001018
Koch A, Cascorbi I, Westhofen M, Dafotakis M, Klapa S, Kuhtz-Buschbeck JP. The Neurophysiology and Treatment of Motion Sickness. Dtsch Arztebl Int. 2018;115(41):687-96. https://doi.org/10.3238/arztebl.2018.0687
Schmäl F. Neuronal mechanisms and the treatment of motion sickness. Pharmacology. 2013;91(3-4):229-41. https://doi.org/10.1159/000350185
Cha YH, Golding JF, Keshavarz B, Furman J, Kim JS, Lopez-Escamez JA, et al. Motion sickness diagnostic criteria: Consensus Document of the Classification Committee of the Bárány Society. J Vestib Res. 2021;31(5):327-44. https://doi.org/10.3233/ves-200005
Paillard AC, Quarck G, Paolino F, Denise P, Paolino M, Golding JF, et al. Motion sickness susceptibility in healthy subjects and vestibular patients: effects of gender, age and trait-anxiety. J Vestib Res. 2013;23(4-5):203-9. https://doi.org/10.3233/ves-130501
Leung AK, Hon KL. Motion sickness: an overview. Drugs Context. 2019;8. https://doi.org/10.7573/dic.2019-9-4
Shupak A, Gordon CR. Motion sickness: advances in pathogenesis, prediction, prevention, and treatment. Aviat Space Environ Med. 2006;77(12):1213-23. PMID: 17183916
Brainard A, Gresham C. Prevention and treatment of motion sickness. Am Fam Physician. 2014;90(1):41-6. PMID: 25077501
Chu H, Li MH, Juan SH, Chiou WY. Effects of transcutaneous electrical nerve stimulation on motion sickness induced by rotary chair: a crossover study. J Altern Complement Med. 2012;18(5):494-500. https://doi.org/10.1089/acm.2011.0366
Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009(2):Cd003281. https://doi.org/10.1002/14651858.cd003281.pub3
Cha YH, Deblieck C, Wu AD. Double-Blind Sham-Controlled Crossover Trial of Repetitive Transcranial Magnetic Stimulation for Mal de Debarquement Syndrome. Otol Neurotol. 2016;37(6):805-12. https://doi.org/10.1097/mao.0000000000001045
Invencio-Da-Costa, L. F., Sánchez-Blanco, C., Yáñez-González, R., Sánchez-Gómez, H., Peña-Navarro, P., Pacheco-López, S., Marcos-Alonso, S., Almeida-Ayerve, C. N., Cabrera-Pérez, L., & Díaz-Sánchez, V. (2023). Mareo y vértigo ortostático, funcional y cinetosis. Revista ORL, e31540. https://doi.org/10.14201/orl.31540
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