Patient's question:
Last night, I suddenly felt dizzy, like the house was spinning around.Doctor's answer:
This phenomenon is relatively common among children and adolescents and is medically referred to as "orthostatic dysregulation." It is more prevalent in primary and middle school students aged 7 to 12, with an incidence rate of approximately 10% to 15% among school-aged children. Children with this condition not only experience morning dizziness but also exhibit reluctance to get up, slow movements upon rising, pale complexion, and symptoms such as nausea and vomiting. When these children engage in physical education, they may feel dizzy, blurred vision, chest tightness, and palpitations when standing for a slightly longer period or when rising from a squatting position. Some may experience palpitations and shortness of breath even with slight activity and thus avoid movement. Others may be prone to motion sickness and dislike amusement park rides such as merry-go-rounds, Ferris wheels, swings, and carousels. In rare, severe cases, children may faint upon rising, falling to the ground and reporting, "Everything went black in front of my eyes, and I lost consciousness after that," but symptoms return to normal after lying down for a rest. As a result, many parents mistakenly believe their children are intentionally "being lazy" and reluctant to study, often scolding and criticizing them, which indicates a lack of understanding of their children's physiological characteristics.Generally, when the body is in different positions, the distribution of blood throughout the body varies. In healthy individuals, when transitioning from lying down, sitting, or squatting to standing, the autonomic nervous system regulates leg muscle tension and blood vessel constriction, allowing blood pooled in the lower body to return to the heart. This ensures the heart has sufficient blood to redistribute, meeting the demands of vital organs such as the brain and heart and maintaining normal physiological functions. However, children have immature and unstable autonomic nervous systems. When their body position changes, they cannot quickly regulate the dilation and constriction of blood vessels and the heart. This leads to temporary insufficient blood supply to the upper body, resulting in orthostatic dysregulation symptoms. The severity of orthostatic dysregulation can vary greatly, but its main characteristics include symptoms occurring during position changes or when standing for a slightly longer period. These symptoms are merely temporary and disappear once the body position is fixed or the autonomic nervous system functions normally.
When a child has orthostatic dysregulation, parents need not be overly anxious, as this condition is not caused by underlying abnormalities in the heart, brain, or gastrointestinal tract but rather by an immature and unstable autonomic nervous system. It is a temporary phenomenon during a child's growth and development, gradually improving or resolving with age. Some children may experience the condition for several years, so parents should help alleviate their concerns, wake them up earlier each day, and advise them to move their limbs in bed before getting up. Rising should be done slowly and gently. Encourage children to splash cold water on their faces and rub their limbs regularly to exercise and improve blood vessel function, enhancing their body's tolerance. If necessary, appropriate medication to regulate the autonomic nervous system can be prescribed, such as 20 mg of oryzanol taken three times daily, with a course of 1 to 3 months until recovery.