Vestibular Paroxysmia

To find more about the symptoms, causes, treatment, and best practices of Vestibular Paroxysmia, see below.

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About the Disease

It is a clinical syndrome caused by compression of the vestibular nerve. The main clinical feature is brief recurrent spells of vertigo.

Causes of Vestibular Paroxysmia

Nerve compression or damage due to by:

  • Blood vessels – microvascular compression (MVC)
  • Vestibular Neuritis
  • A tumour – such as an acoustic neuroma
  • Radiation – such as post gamma knife
  • Surgery on the 8th nerve

Microvascular compression is one of the most common reasons for vestibular paroxysmia.

Symptoms

The patient may complain of spells of vertigo or dizziness lasting from seconds to minutes and may occur several times per day.

Diagnosis

The following tests are advised for evaluating the condition and its severity:

  • MRI Brain – If available, 3D MRI with FT-FISS or CISS is preferable.
  • Positive in 95%
  • Videonystagmography/Electronystagmography — positive in 66%
  • EEG – to rule out seizures
  • Audiometry – positive in 50%
  • Fasting blood glucose – to rule out fluctuating sugar level

Treatment

Neurovascular compression of the cochleovestibular nerve causes Vestibular Paroxysmia. Treatment with carbamazepine or oxcarbazepine is usually effective. Response to these medicines also serves as a diagnostic tool. Vestibular suppressants are not effective in this condition.

If medical treatment does not have the desired outcome, surgery may be done. Microvascular decompression of a vascular loop compressing the vestibular nerve may be done endoscopically with minimal morbidity in expert hands.

Dr. Anita Bhandari

Dr.Anita Bhandari is MS(ENT) and a consultant Neurotologist practising in Jaipur, India. She has done a fellowship in Otology and Neurotology from Singapore. She has set up a state-of-art Vertigo and Ear Clinic in Jaipur (www.vertigoandearclinic.com) which is amongst the most advanced vertigo clinics in India. Dr. Bhandari is actively involved in the development of diagnostic equipment in the field of diagnosis and rehabilitation of vertigo and balance disorders. She has contributed to the development of Computerised Dynamic Visual Acuity, Cranio-Corpography, Subjective Visual Vertical, Video Nystagmography and Posturography diagnostic equipment and has two in this field. She has also been involved in the development of Virtual reality for vestibular rehabilitation. She is Scientific advisor to NeuroEquilibrium™, a unique project to set up 500 super-specialised vertigo and dizziness clinics in India, Asia & Africa leveraging cloud technology. She has authored chapters on ‘Vestibular Physiology’, ‘Dynamic Visual Acuity’, ‘Surgical treatment of vertigo’, ‘Difficult cases in vertigo’ in various Neurotology textbooks. She is an invited speaker in various Vertigo & Neurotology conferences across the world. Dr.Anita Bhandari is MS(ENT) and a consultant Neurotologist practising in Jaipur, India. She has done a fellowship in Otology and Neurotology from Singapore. She has set up a state-of-art Vertigo and Ear Clinic in Jaipur (www.vertigoandearclinic.com) which is amongst the most advanced vertigo clinics in India. Dr. Bhandari is actively involved in the development of diagnostic equipment in the field of diagnosis and rehabilitation of vertigo and balance disorders. She has contributed to the development of Computerised Dynamic Visual Acuity, Cranio-Corpography, Subjective Visual Vertical, Video Nystagmography and Posturography diagnostic equipment and has two in this field. She has also been involved in the development of Virtual reality for vestibular rehabilitation. She is Scientific advisor to NeuroEquilibrium™, a unique project to set up 500 super-specialised vertigo and dizziness clinics in India, Asia & Africa leveraging cloud technology. She has authored chapters on ‘Vestibular Physiology’, ‘Dynamic Visual Acuity’, ‘Surgical treatment of vertigo’, ‘Difficult cases in vertigo’ in various Neurotology textbooks. She is an invited speaker in various Vertigo & Neurotology conferences across the world.

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You need not suffer in silence now. You need not accept vertigo as ‘something you have to live with’. There is a way to cure vertigo, dizziness and any other balancing issues you are facing. Live a stable and vibrant life.

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