Clinical features of 51 patients with vestibular paroxysmia

Objective To explore the clinical features of vestibular paroxysmia (VP). Methods The clinical features of 51 patients with VP from January 2009 to April 2011 were analyzed retrospectively. The treatment effectiveness of antiepileptics was evaluated. Results The ratio of male to female was 1∶1.55 in the 51 patients with VP and the course of disease was 10 days to 20 years.In 46 patients (90.2%) the attacks occurred at rest，whereas 37 patients (72.5%) were precipitated by a head turn or a body turn.Three minutes hyperventilation-induced vertigo was found in 13 patients (25.5%) and Fukuda test was positivein 15 patients (29.4%).Forty patients (78.4%) were abnormal in brainstem auditory evoked potentials (BAEP) and the interpeak latency of wave Ⅰ-Ⅲ was prolonged than 2.2 ms in 26 patients (51.0%). There were 47 ears had neurovascular cross-compression (NVCC)，which were unilateral in 37 patients and bilateral in 5 patients，with type Ⅰ in 23 ears (48.9%)，type Ⅱ in 5 ears (10.6%)，type Ⅲ in 17 ears (36.2%) and type Ⅳ in 2 ears (4.3%).Three month-treatment led to a significant reduction in the attack frequency (3 (2，7) per month vs 15 (9，30) per month，Z=-6.156，P<0.01)，in the attack duration (2 (1，4) s vs 12 (6，20) s，Z=-6.066，P<0.01)，and a reduction in the visual analogue scale of vertigo (1.86±0.57 vs 5.83±1.12，t=1.984，P<0.01). Conclusions Brief vertigo attacks at rest is the character of VP.Three minutes hyperventilation-induced vertigo is helpful for the diagnosis of VP.The prolongation of the interpeak latency of wave Ⅰ-Ⅲ in BAEP is the character of VP.NVCC widely existed in the patients with VP and types Ⅰ and type Ⅲ was more common.Using antiepileptics，a better treatment effectiveness can be obtained. Key words: Vertigo; Seizures; Evoked potentials，auditory，brain stem; Anticonvulsants; Diagnostic imaging