Vestibular Paroxysmia is a disorder that is caused by irritation or compression in the eighth cranial nerve known as the vestibulocochlear nerve. An episodic vestibular disorder known as vestibular Paroxysmia is well known for the high frequency of attacks in patients. It was earlier known as “disabling positional vertigo.”
The vestibulocochlear nerve flows through the inner ear which is responsible for sending the sensory signal to the brain for maintaining balance and supplies cochlea which is responsible for hearing.
People suffering from Vestibular Paroxysmia may experience frequent bouts of vertigo accompanied by other vestibular Paroxysmia symptoms. Apart from vascular compression, many possible Vestibular Paroxysmia causes lead to nerve irritability. Vestibular Paroxysmia is also known as microvascular compression syndrome (MVC).
Patients suffering from MVC (microvascular compression syndrome) may experience irritation of the vestibular portion of the 8th cranial nerve due to blood vessels that lead to spells of vertigo and motion sickness. The symptoms of microvascular compression syndrome can be treated well with medications of neuralgia as it responds well to it. Vestibular Paroxysmia symptoms are chronic and persistent and last for a longer duration i.e. for more than three months. Patients suffering from vestibular Paroxysmia may experience hundreds of attacks within a year as per the nature of the disease. It is recommended to seek medical help as soon as you start observing any vestibular Paroxysmia symptoms.
The symptoms of vestibular Paroxysmia are often confused with symptoms of other diseases like Meniere disease or simple intolerance of motion, migraines, etc. as they show similar sets of symptoms. An expert doctor will diagnose the underlying cause of the disease and would suggest the best vestibular Paroxysmia treatment and prescribe medications that will help in easing out the symptoms. If a patient is experiencing vestibular Paroxysmia symptoms due to blood vessels then your doctor may advise you to undergo surgical treatment and if symptoms are caused due to other potential causes, he would suggest you with certain medications and vestibular Paroxysmia treatments to ease the symptoms.
Vestibular Paroxysmia Causes
Vestibular Paroxysmia is majorly caused by the irritation in the vestibular nerve. The irritation or compression caused in the vestibular portion of the 8th cranial nerve by a blood vessel leads to Vestibular Paroxysmia. There are other possible causes too apart from blood vessels that lead to Vestibular Paroxysmia. When a nerve is compressed by blood vessels it is known as microvascular compression (MVC). Tumour, radiation & surgery on the 8th cranial nerve are the other possible causes of nerve damage or nerve compression in a patient that causes Vestibular Paroxysmia. Anything that irritates the vestibular nerve or central vestibular pathways, causes a similar set of symptoms as Vestibular Paroxysmia.
What are vestibular Paroxysmia symptoms?
A patient suffering from Vestibular Paroxysmia may experience any one symptom or a combination of symptoms. It is often confused with the symptoms of other diseases as they are quite similar. Your doctor will help in diagnosing the symptoms closely and identify the underlying cause of an ailment and from which disease a patient is suffering.
Let’s have a look at some common Vestibular Paroxysmia symptoms:
1. A patient may experience sudden bouts of vertigo spells or dizziness which lasts for a fraction of seconds to minutes to hours.
2. A patient may experience recurring episodes of vertigo.
3. The patient may experience a high frequency of attacks which ranges from a few attacks per month to 30 attacks per day.
4. You may experience sudden attacks that are triggered by head movements or by hyperventilation.
5. A person may lose balance or feel unsteady if attacks occur while standing and walking.
6. During the attack, a patient may hear a ringing sensation known as tinnitus which can be heard in one ear.
7. Sensitivity to sound during the attack.
8. A patient may experience chronic attacks. It lasts for at least 3 months or a longer duration.
Diagnosis of vestibular Paroxysmia
Your doctor may diagnose the underlying condition based on the symptoms experienced by the patient. It becomes extremely important for the doctor to rule out other diagnoses of the disease such as including Meniere’s disease, vestibular migraine, benign paroxysmal positional vertigo (BPPV), epileptic visual aura, multiple sclerosis (MS), etc. which show a similar set of symptoms. An expert doctor will closely seek your medical history and will ask you to undergo various diagnostic tests. MRI is a well-known test that is advised by doctors to diagnose Vestibular Paroxysmia. It is used to visualize the compression of the 8th cranial nerve.
Here are diagnostic criteria for definite and probable vestibular paroxysmia:
Definite vestibular paroxysmia
- You may experience at least 10 attacks of spinning or non-spinning vertigo.
- It may last for less than a minute.
- It occurs spontaneously.
- Stereotyped phenomenology in a particular patient.
- Patient show response to certain neuralgia medications such as carbamazepine/oxcarbazepine.
Probable vestibular Paroxysmia
- You may experience a minimum of 5 attacks of spinning or non-spinning vertigo.
- It may last for less than 5 minutes.
- It may occur spontaneously or get triggered by certain head movements.
- Stereotyped phenomenology in a particular patient.
- You may experience other symptoms of vertigo.
Vestibular Paroxysmia treatment
After diagnosing your condition, your doctor may suggest medicinal treatment or surgical treatment for treating vestibular Paroxysmia.
Microvascular compression syndrome responds well when treated with neuralgia medications. Some of the commonly prescribed medications of neuralgia are carbamazepine, Oxcarbamazine, eslicarbazepine (Aptiom), levatiracetam (Keppra), etc. It helps in treating patients with Vestibular Paroxysmia if the compression is not caused due to blood vessels. Treatment with these anti-seizure medications helps in reducing the intensity, frequency, and duration of attacks. If a patient shows a positive response to these medications it helps in curing the disease much faster.
If a patient is experiencing compression or irritation in the vestibular nerve due to blood vessels, surgery could be one of the Vestibular Paroxysmia treatments. Surgery treatment is the last option recommended by doctors if patients don’t show any improvements with medications or develop medication intolerance.