SINGAPORE – Children who experience chronic dizziness may suffer in silence for a long time, especially if they are unable to describe their conditions.
Many can, however, get relief almost immediately with the appropriate treatment. This could involve medication and lifestyle adjustments such as getting ample sleep.
This is why a team of healthcare professionals at KK Women’s and Children’s Hospital (KKH) hopes that young patients can get diagnosed earlier, urging parents and caregivers to bring their children with symptoms in.
In 2024, KKH’s otolaryngology (also known as ear, nose and throat, or ENT) clinic saw about 50 new cases of chronic dizziness, translating to about one child or teenager on average turning up at the clinic each week.
Dr Chan Ching Yee, a senior consultant at KKH’s otolaryngology department, said chronic dizziness involves experiencing symptoms for more than three months.
The child may also experience migraine – a throbbing headache which may be accompanied by sensitivity to light. This is typically more common for those of upper primary school age or older, but is infrequent in younger children.
There are many possible causes of dizziness, such as different types of ear conditions, stroke, migraine, neck conditions and concussion, said Dr Chan.
She added: “The key is to make the right diagnosis, to put in place the correct treatment strategies.”
Dr Chan said her department sees many young patients who have been given medication to treat their dizziness symptoms.
But the underlying cause of the dizziness was not treated or the diagnosis was wrong, with some suffering for years and referred from physician to physician without improvement.
In 2024, KKH set up a paediatric balance clinic aimed at helping patients first validate that their symptoms are real and then receive a medical diagnosis and appropriate treatment, and hopefully regain quality or normalcy of life.
The multidisciplinary team at KK Women’s and Children’s Hospital’s paediatric balance clinic includes (from left) principal physiotherapist Vellaichamy Maheswari, senior consultant of neurology service Loh Ne-Ron, senior consultant at the otolaryngology department Chan Ching Yee and audiologist Isshani Devaraj.
ST PHOTO: LUTHER LAU
International studies show that around 30 per cent of children and adolescents experience balance dysfunction, which could include dizziness, vertigo (spinning sensation), imbalance or unsteadiness.
One such young patient who sought help at KKH’s paediatric balance clinic was Shannon Soh, 16, who had to deal with episodes of giddiness since she was nine.
The episodes lasted longer the older she got, but she did not seek medical help.
“It appeared to come randomly as the triggers were not consistent. For instance, it could come when I did not take my breakfast, but also on days when I had my breakfast, so it was hard to predict when I would feel giddy,” said the student.
Dr Chan Ching Yee (left) demonstrating a balancing exercise used to assess and gauge Shannon Soh’s dizziness.
ST PHOTO: LUTHER LAU
She added that she also suffered from sensitivity to light and would experience giddiness, for instance when standing at traffic junctions and watching cars zip past her.
In Secondary 2, one particularly bad giddiness episode resulted in her being taken to the sickbay for first aid.
She was advised to seek specialist care to “find out what is wrong and fix the problem”.
A senior consultant otorhinolaryngologist at KKH’s ENT clinic first attended to her. Then she was referred to Dr Chan’s paediatric balance clinic.
On her first visit to Dr Chan’s clinic in early 2024, she was diagnosed with vestibular migraine, a neurological condition which causes dizziness, vertigo and balance problems.
After starting on a regimen of vitamin B2 and magnesium supplements, Shannon’s condition has improved. The dizziness episodes are now shorter and she no longer takes headache medication.
Studies have shown that vitamin B2 and magnesium help to reduce the frequency, duration and severity of vertigo, helping patients who suffer from vestibular migraine.
According to some overseas studies, magnesium helps with nerve function and inflammation, while vitamin B2 helps in the creation of red blood cells, bringing about migraine relief as deficiencies of red blood cells are linked to dizziness.
The KKH team added that while the exact mechanisms are still being studied, both magnesium and vitamin B2 are likely to relieve migraines by reducing different types of inflammation within the nervous system.
Dr Chan said this does not mean that patients have to be on medication for life.
She also said it is not recommended that people take these supplements without seeing a doctor first.
This is because the combination of vitamin B2 and magnesium may not work for all patients with similar symptoms, even though it is the first line of treatment for vestibular migraine. Other concerns are that the dosage may not be what is medically necessary, and there could be underlying issues that are more serious and require urgent medical attention.
For instance, if there are persistent headaches, vomiting or worsening balance issues, these could point to much more serious issues such as brain tumours, said Dr Chan.
Dr Loh Ne-Ron, a senior consultant at KKH’s neurology service, said: “If your condition stops you from doing normal activities, you should seek help.
“For younger children who cannot express themselves well, parents and caregivers could possibly use their gut instinct to determine if help is needed.”
