Clinical Features and Therapeutic Effects of Vestibular Paroxysmia / 听力学及言语疾病杂志

ABSTRACT

Objective To investigate the clinical features and the therapeutic effects in patients with vestibu-lar paroxysmia(VP) .Methods A total of 32 patients with VP were analyzed retrospectively through pure -tone au-diometry (PTA) ,auditory brainstem response(ABR) ,magnetic resonance imaging (MRI) ,and vestibular function . The effects were assessed after 3 months treatment of carbamazepine (CBZ) or oxcarbazepine (OXA) .Results The main clinical symptom of 32 patients was a brief spell of vertigo ,and 75% of patient's attacks were regularly precipi-tated by certain head positions or position changes .The most common accompanying symptom was unsteadiness of stance or gait (75 .00% ) .The PTA thresholds were elevated in 11 patients (34 .38% ) .MRI in all patients showed neurovascular cross -compression(NVCC) .Among 30 patients who performed ABR tests ,24 (80 .00% ) were ab-normal and 19 patients (63 .33% )were found that the interpeak latency (IPL) of wave I-III( IPL I-III) prolonged more than 2 .2 ms .The course of the patients with IPL I -III prolonged was relatively longer (P=0 .231) ,but there was no significantly difference .All patients received carbamazepine (CBZ) or oxcarbazepine (OXA) for one month .One case was lost to follow -up ,4 had no symptom improvement and 27 had a significant reduction in the attack frequency and intensity respectively after treatment of one month ,two months ,three months and 6 months of the drug withdrawal ,compared with the previous (P<0 .05) .The level of vertigo was significantly improved(P<0 .05) .Conclusion Episodic spells of vertigo are the main clinical symptom of VP ,regularly caused by certain head positions or position changes .The NVCC can be found by MRI in all patients .The IPL I -III in ABR was pro-longed in most patients ,some of them have hearing loss .CBZ and OXA are effective with VP and also significant in the experimental treatment of diagnosis .