Pediatric emergency medicine trisk 0552 0552
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FIGURE 24.2 Approach to the child with pseudovertigo. EKG, electrocardiogram.
Children with severe or recurrent attacks of vertigo may require treatment with
specific medications. The antihistamines dimenhydrinate (12.5 to 25 mg orally
every 6 to 8 hours, maximum dose 75 mg per day for ages 2 to 6 years and 25 to
50 mg every 6 to 8 hours for ages 6 to 12 years, maximum dose 150 mg per day)
and meclizine (12.5 to 25 mg orally every 12 hours in children older than 12
years of age) may be helpful. Concomitant use of a benzodiazepine such as
diazepam (0.1 to 0.3 mg/kg/day orally divided every 6 to 8 hours, maximum 10
mg per dose) as a sedative may be necessary in severe cases.
Pseudovertigo
Pseudovertigo ( Fig. 24.2 ) refers to a broad array of symptoms such as
lightheadedness, presyncope, intoxication, ataxia, visual disturbances,
unsteadiness, stress, anxiety, and fear. Uniformly absent are a sense of rotation
and ocular nystagmus. Underlying causes are numerous; several of the most
common causes are listed in Table 24.3 (see also discussions of syncope in
Chapter 76 Syncope ). Careful consideration of the patient’s age, gender, detailed
