Vestibular Dysfunction in Pediatric Patients With Congenital Cytomegalovirus Infection and Hearing Loss: Occurrence and Characteristics.

OBJECTIVE

To explore the occurrence of vestibular dysfunction in pediatric patients with congenital cytomegalovirus (CMV) infection and define the characteristics of vestibular loss in this population.

STUDY

DESIGN

Retrospective study with controls.

SETTING

Tertiary pediatric referral center.

PATIENTS: Pediatric patients with hearing loss associated with congenital CMV infection and GJB2 mutation(s).

INTERVENTIONS: Balance and vestibular evaluation.

MAIN OUTCOME MEASURES: Normal versus abnormal results of laboratory vestibular testing.

RESULTS

A total of 50 pediatric patients with congenital CMV infection, average age = 3.4 years (ranging from 7 mo to 12 yr, SD = 2.9 yr), underwent vestibular workup, including Videonystagmography, rotary chair test, and cervical vestibular evoked myogenic potential test. Of these children with CMV infection, 35 (70%) had bilateral vestibular loss, 7 (14%) had unilateral loss, and only 8 (16%) had a normal vestibular workup. In contrast, among the 48 pediatric patients without a history of CMV infection and with hearing loss associated with GJB2 mutation(s), only 9 (19%) had bilateral vestibular loss, 2 (4%) had unilateral loss, while 37 (77%) had a normal vestibular workup. Developmental/motor delay was documented in 35 (70%) patients with congenital CMV infection and hearing loss.

CONCLUSIONS

Children with congenital CMV infection are at high risk for vestibular loss, which is frequently bilateral, impacting the semicircular canals and otolith organs, not just the well-known hearing loss. A comprehensive balance and vestibular workup is warranted for children with congenital CMV infection with the goal of early identification of vestibular dysfunction and earlier management.