vestibular paroxysmia

Etiology

• neurovascular cross-compression of cranial nerve 8

Clinical manifestations

• vertigo attacks (seconds to minutes long) occurring at rest & with head turns, position change, or hyperventilation in 50% of patients, only at rest in 28%, & only with provocation in 22%
• 28% with accompanying auditory symptoms
• most with evidence of unilateral auditory or vestibular damage

Radiology

• MRI of the brain
  • shows neurovascular cross-compression of cranial nerve 8 in almost all cases
  • many unaffected individuals have similar MRI findings

Management

• most patients respond to carbamazepine or oxcarbazepine

More general terms

• central vertigo