Paroxysmal tinnitus and nystagmus accompanied by facial spasm

A case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, in which neurovascular decompression was performed, is reported. The paroxysmal tinnitus and nystagmus were synchronous with each other. Horizontal nystagmus with a rotary component was found to be counterclockwise during the brief attack of tinnitus, whereas its direction became clockwise while free of tinnitus. The patient has been postoperatively relieved not only of the facial spasm, but also of the tinnitus and nystagmus. The mechanism of the occurrence of the syndrome and the significance of the neurootologic examination are discussed.