Abstract:

The diagnosis and management of pediatric dizziness/vertigo represent a complex clinical challenge involving multiple disciplines. The primary difficulties stem from two key aspects: firstly, children's limited expressive ability often leads to unclear symptom description; and secondly, the vestibular-emotional-cognitive network interactions during development are more complex than in adults. Consequently, conducting appropriate psychological assessments for children with dizziness/vertigo, particularly when comorbid anxiety or depression is suspected, remains particularly challenging. This article integrates international evidence-based findings from the past decade with the author's clinical experience in multidisciplinary clinics to systematically analyze differences and blind spots in assessment objectives, tool selection, and referral timing among otolaryngology, neurology, and psychiatry/psychology departments. Current major issues include the inappropriate application of adult assessment scales in younger populations, insufficient recognition of emotional comorbidities, and inadequate inter-specialty communication. The paper proposes establishing a symptom duration-, frequency-, and functional impairment-based staged assessment model to balance underdiagnosis versus premature labeling of psychosomatic conditions. It recommends implementing a three-tier collaborative pathway of "neurology initial consultation - otology vestibular assessment - psychology consultation" and adopting a clinician-child-parent "triangular" communication approach to minimize information bias. Future work should focus on establishing nationwide multicenter norms for neuropsychological assessment and referral standards for pediatric dizziness/vertigo, thereby providing evidence-based foundation for developing Chinese expert consensus.

Key words: vertigo, multiple disciplines, neuropsychological assessment, child