Balance disorders in children after cranial-cerebral trauma with total damage to the vestibular apparatus

IntroductionPosttraumatic 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.AimThe aim of this paper is to provide with easily accessible and unsophisticated therapy methods applied in children with total damage to vestibular system.Case studyThis paper presents a case of a 6-year-old boy who has suffered from cranial-cerebral 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 discussionDiminution 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.ConclusionsEasily 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.