Vestibular Paroxysmia: A Four-Case Report

Area of Science:

• Neurology
• Otolaryngology

Background:

• Vestibular paroxysmia (VP) is a rare neurovascular compression disorder affecting the vestibulocochlear nerve.
• It is characterized by demyelination resulting from vascular loop compression and ephaptic transmission.

Observation:

• Four patients over 40 with recurrent vertigo, unresponsive to prior treatments, were studied.
• Symptoms included spontaneous or head-movement-triggered vertigo episodes.
• MRI revealed neurovascular compression of the VIII cranial nerve in all patients.

Findings:

• Oxcarbazepine treatment led to a positive response in all four patients.
• This suggests a strong therapeutic effect of oxcarbazepine in VP.
• The study reinforces the diagnostic criteria and treatment response for VP.

Implications:

• VP diagnosis can be challenging due to its rarity.
• A trial of medication, specifically oxcarbazepine, should be considered for suspected VP cases.
• This approach can aid in diagnosing and managing this vestibular syndrome effectively.