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Sodium Channel Blockers for Vestibular Paroxysmia in Children

Pierre Reynard1,2, Hung Thai-Van1,2,3, Eugenia Mustea1

  • 1Department of Audiology and Otoneurological Explorations, Civil Hospitals of Lyon, 69003 Lyon, France.

Audiology Research
|June 25, 2025
PubMed

Insights

Vestibular paroxysmia (VP) in children is a treatable cause of vertigo. Sodium channel blockers like oxcarbazepine and carbamazepine show promising results, offering fast relief for pediatric patients.

Area of Science:

  • Neurology
  • Pediatrics
  • Otolaryngology

Background:

  • Vestibular paroxysmia (VP) is increasingly recognized in children, accounting for up to 4% of pediatric vertigo cases.
  • A positive therapeutic response to sodium-channel-blocking drugs has been observed in pediatric VP.

Purpose of the Study:

  • To review the current literature on vestibular paroxysmia in children.
  • To provide guidance on the diagnosis and treatment of pediatric VP.

Main Methods:

  • A comprehensive literature search was conducted using PubMed, Medline, Cochrane, and Crossref databases.
  • Studies focusing on VP in children and the use of sodium channel blockers were selected for review.

Main Results:

  • Limited evidence exists, with only five articles (case series/reports) identified.
  • Oxcarbazepine (300-360 mg/day) and carbamazepine (50-200 mg/day) are the primary treatments, with efficacy reported within one week.
  • Treatment duration typically spans six weeks.

Conclusions:

  • Vestibular paroxysmia is a recognized condition in pediatric patients.
  • Sodium channel blockers appear effective for pediatric VP, mirroring adult responses.
  • Increased awareness is crucial for identifying this treatable cause of episodic vertigo in children.

Keywords:
carbamazepinecross compression syndromenarrowed internal auditory canaloxcarbazepinesodium channel blockersvestibular paroxysmia

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