Vestibular testing in children.

Vestibular evaluation in the pediatric population has in the past taken several forms. For the most part, the pediatric vestibular evaluation has been more subjective than objective. One of the primary reasons for this has been the obvious difficulties encountered in trying to conduct a standard, adult electronystagmography (ENG) procedure on a pediatric patient population not capable of performing in a manner conductive to a good ENG recording. The purpose of this paper is to suggest certain modifications of the standard adult ENG battery for use with young children and infants. Discussion consists of modifications in the areas of various ocular movement tests including sinusoidal pursuit, calibration, optokinetics and gaze testing. In addition, procedures relative to peripheral vestibular output from perrotational and caloric stimulation are discussed. Topics also include the use of a closed-loop caloric irrigator and simultaneous caloric irrigation as viable alternatives to standard, alternative water irrigation when testing the vestibular output of a young child or infant.