A Case of Vestibular Paroxysmia Offended by Vertebral Artery / 대한이비인후과학회지

ABSTRACT

Vestibular paroxysmia, which is caused by neurovascular cross-compression of the eighth cranial nerve, is characterized by recurrent vertiginous spells and other audiologic symptoms such as tinnitus, aural fullness and hearing impairment. Magnetic resonance image may show the eighth cranial nerve compression by vessels in the posterior fossa such as the anterior-inferior cerebellar, posterior-inferior cerebellar, basilar, or vertebral arteries. Medical therapy including carbamazepine, phenytoin or gabapentin and microvascular decompression of the eighth cranial nerve can be contemplated. Here, we report of a 51 year-old man who presented with recurrent vertigo attacks and tinnitus. His symptoms were aggravated by positional change. Videonystagmography and auditory brainstem response showed abnormal results. Magnetic resonance image showed the eighth cranial nerve compression caused by the vascular loop. The offending vessel was revealed as vertebral artery. He was treated with carbamazepine and showed no recurrent symptoms. We report this rare case with a review of the relevant literatures.