Clinical Feature And Medical Treatment Of Vestibular Paroxysmia

Objective:To explore the clinical features of vestibular paroxysmia(VP) and evaluate the significance of audiology and imaging in the diagnosis of VP and the therapeutic efficacy of antiepoleptics. Methods:41 patients with VP in outpatient were performed with physical examination, audiology examination and MRI.And the latter was applied on 47 patients with sudden hearing loss to judge if there was neurovascular compression(NVC) and compare the differences of the results between two groups.The visual analogue scale(VAS) should be used to evaluate the control of vertigo symptoms about VP patients before and after the treatment of antiepileptics. Results:41 patients with VP included 16 male patients and 25 female ones, the ratio of male to female was 1:1.56 and the average age was 51.7 ± 11.7 years.The main clinical symptom was a brief spell of vertigo and the majority of patients had a predisposing factor before onset.In 33 patients(80%)the attacks occurred when head or body position changed,whereas 25 patients(68%)were precipitated at rest.In 23 patients(56%) three minutes hyperventilation could induce vertigo. The auditory brainstem response(ABR) was abnormal in 30 patients(73%),25 patients among them had the interpeak latency of wave I-III prolonged than 2.2ms.36 patients with 50 ears existed NVC in VP group,while 24 patients with 31 ears were found NVC in sudden hearing loss group.The difference of two groups was statistically significant. After one month、two months and three months of the medicine treatment,there was a significant reduction respectively in the attack frequency and intensity. Conclusions:1.The main clinical symptom of VP is episodic spells of vertigo,there were many predisposing factors before onset like head or body position changing;The interpeak latency of wave I-III in ABR was often prolonged and MRI prompted the NVC frequently; And a better efficacy can be obtained by using antiepileptics,.2. Though ABR and MRI benefit the diagnosis of VP, the clinical diagnosis can not only rely on the additional tests,but also should mainly rely on histories and exclusion diagnoses.And the experimental treatment of antiepileptics is also important in diagnosis.