| Objective: To analyze the clinical characteristics of Vestibular Paroxysmia(VP),be familiar with its features,and improve the diagnosis and treatment rate of VP.Methods: sixteen patients with VP or probable VP,who had admitted into the First Affiliated Hospital of Chongqing Medical University from March 2014 to July 2018,were included into this study.All these clinical data of signs and symptoms,examinations,admitting diagnosis,final diagnosis,treatment methods and effects were retrospectively analyzed.Result:(1)Clinical symptoms: 10 cases with nausea and vomiting,8cases with hearing loss and 11 cases with tinnitus.The duration of symptoms: 7 cases less than 5 minutes,7 cases less than 1 minute and 2cases less than 10 seconds.All the patients had experienced more than 10 attacks of main discomforts,such as vertigo.(2)Admitting diagnosis: 9cases with Meniere’s Disease(MD),1 case with Vertebral Basilar Ischemic Vertigo,2 cases with Benign Paroxysmal Positional Vertigo(BPPV),1 case with Labyrinth fistula,1 case with Sudden Sensorineural Hearing Loss(accompanied with vertigo),1 case with Vestibular Neuronitis(VN),and 1case with right diagnosis of VP.(3)Examinations: 16 patients received Pure Tone Audiometry(PTA),and 11 patients with sensorineural hearing loss.Auditory Brainstem Response(ABR)was detected in 9 patients,and3 patients with abnormal results.15 patients underwent MRI examination,8patients with anterior inferior cerebellar artery crossed with the auditory nerve and compression,2 patients with posterior inferior cerebellar artery crossed with the auditory nerve,and 1 patient with a small vessel shadow intersecting around the auditory nerve.10 patients with Vestibular dysfunction.14 patients underwent Electrocochleogram(EcochG)examination,and 6 patients with abnormal results.11 patients underwent glycerol test and the results were negative.Vestibular Evoked Myogenic Potentials(VEMPs)were examined in 8 patients and 6 patients with abnormal results.The vertigo symptoms of 15 patients who were admitting diagnosis as other vertigo diseases did not relieve after corresponding treatment.Other vertigo diseases were excluded according to signs and symptoms,examinations.the vertigo symptoms of all patients were alleviated to varying degrees after treatment with anti-epileptic drugs(carbamazepine or oxipine).According to the diagnostic criteria of VP,9patients were finally diagnosed as VP and 7 patients could be diagnosed as probable VP.Conclusion: The diagnosis of VP mainly depends on its clinical symptoms,audiology and vestibular examinations,typical imagingmanifestations.Because of the lack of specificity in clinical manifestations,it is easy to be misdiagnosed.It should be distinguished from MD,BPPV,vertebral basilar ischemic vertigo,Vestibular Migraine(VM),SSNHL(accompanied with vertigo),VN,etc.Clinicians should strengthen the understanding of the disease and improve the diagnosis and treatment rate of VP. |
