Background: Vestibular disorders are common among children, but often undiagnosed due to lack of vestibular assessment. Diagnosis achieved through assessment of vestibular and neurological functions.

Objectives: The present work aims to evaluate vestibular findings and detect the complementary role of vestibular to neurological assessment in dizzy children.

Subjects and methods: This observational, case-control study involved 40 children: 20 healthy children and 20 children experiencing dizziness. All participants underwent full history taking, otological examination, basic audiological evaluation, neurological evaluation (clinical neurological examination, magnetic resonance imaging [MRI], and electroencephalography [EEG]), vestibular assessment (office tests and VNG), and the pediatric dizziness questionnaire.

Results: Clinical neurological assessment of dizzy children revealed normal findings. However, EEG exhibited two patients with epilepsy, while MRI displayed positive findings in one case. However, vestibular assessment revealed impaired vestibular functions in the study group. Using VNG, showed higher latency and lower velocity of saccadic test in both directions in study group compared to control group. The pediatric dizziness questionnaire showed mean vestibular category score of 4.1 ± 2.51 and mean neurological category score of 3.2 ± 2.19. The questionnaire revealed that 45% of cases had vestibular disorders, 35% had neurologic disorders, and 20% had combination of both.

Conclusion: Neurological examinations alone fail to diagnose dizziness in children. Despite low prevalence of cases diagnosed with MRI and EEG, they remain important for uncovering obscure conditions. Additionally, vestibular assessment in dizzy children is a useful tool for diagnosing vestibular lesions. The pediatric dizziness questionnaire complements findings of vestibular and neurological assessments.