Patient's question:
Last night, I suddenly felt dizzy, as if 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% in 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.Children with this condition may feel dizzy, lightheaded, chest tightness, or palpitations during physical education class when standing for a slightly longer period or when rising from a squatting position. Some may experience palpitations and shortness of breath with minimal 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 even faint upon standing, 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" or reluctant to study, often scolding and criticizing them, which demonstrates a lack of understanding of their children's physiological characteristics.
Generally speaking, when the human body is in different postural states, blood distribution 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 while maintaining normal physiological functions. However, children have underdeveloped and unstable autonomic nervous systems. When their posture changes, they cannot quickly control 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 occurring during postural changes or when standing for a short period. It is merely a temporary blood supply shortage, and symptoms will resolve on their own once the posture is fixed or the nervous system's regulatory functions return to normal.
When a child has orthostatic dysregulation, parents need not be overly anxious, as this condition is not caused by actual damage to organs such as the heart, brain, or gastrointestinal tract. Instead, it results from an underdeveloped and unstable autonomic nervous system, a temporary phenomenon during a child's growth and development that gradually improves or resolves with age. Some children may experience symptoms for several years, and parents should help alleviate their concerns by waking them up earlier each day and advising them to gently move their limbs in bed before getting up. Rising should be done slowly and without sudden movements. Encourage the child to regularly splash cold water on their face and limbs to exercise and improve blood vessel dilation and constriction, enhancing the body's tolerance. If necessary, appropriate medication to regulate the autonomic nervous system can be prescribed, such as 20 milligrams of oryzanol taken three times daily, with a course of 1 to 3 months until recovery.