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Case report: Bitter vertigo.

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Summary
This summary is machine-generated.

A rare combination of vertigo and taste changes in a patient was caused by basilar artery dolichoectasia compressing cranial nerves. Treatment with lacosamide, a sodium channel blocker, significantly reduced symptoms, suggesting its use for similar neurovascular compression cases.

Keywords:
basilar artery aneurysmcase reportdolichoectasiadysgeusiavertigovestibular paroxysmia

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Area of Science:

  • Neurology
  • Neuro-otology

Background:

  • Vertigo and taste disturbances are rarely concurrent symptoms.
  • Neurovascular compression of cranial nerves can cause complex neurological presentations.

Observation:

  • A 71-year-old patient experienced recurrent vertigo, facial sensory changes, and dysgeusia.
  • Clinical examination revealed a peripheral vestibular deficit.
  • MRI demonstrated basilar artery dolichoectasia compressing the vestibulocochlear and facial nerves.

Findings:

  • The patient's symptoms were attributed to neurovascular compression causing ephatic discharges.
  • Treatment with lacosamide (a sodium channel blocker) markedly decreased symptom frequency and intensity.

Implications:

  • This case highlights basilar artery dolichoectasia as a cause of combined vertigo and dysgeusia.
  • Sodium channel blockers may be effective for treating neurovascular compression syndromes involving taste and vestibular symptoms.