Vestibular paroxysmia (VP): management

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Vestibular paroxysmia (VP): management. Anterior inferior cerebellar artery (AICA). Fully referenced neurology checklist.

Magnetic resonance imaging (MRI): compressing vessels

  • Anterior inferior cerebellar artery (AICA)
  • Posterior inferior cerebellar artery (PICA)
  • Vertebral artery
  • Vertebrobasilar dolichoectasia
  • Veins
  • Neurovascular compression is present in >90% of cases

Brainstem auditory evoked responses (BAER)

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First-line drug treatments

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Second-line drug treatments

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Surgical treatments

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References

  1. Brandt T, Strupp M, Dieterich M. Vestibular paroxysmia: a treatable neurovascular cross-compression syndrome. J Neurol 2016; 263(Suppl 1):S90-S96.
  2. Han J, Wang T, Xie Y, Cao D, Kang Z, Song X. Successive occurrence of vertebrobasilar dolichectasia induced trigeminal neuralgia, vestibular paroxysmia and hemifacial spasm: a case report. Medicine (Baltimore) 2018; 97:e11192.
  3. Ward BK, Gold DR. Tinnitus, oscillopsia, and hyperventilation-induced nystagmus: vestibular paroxysmia. Open J Clin Med Case Rep 2016; 2(7) pii: 1100.
  4. Strupp M, Elger C, Goldschagg N. Treatment of vestibular paroxysmia with lacosamide. Neurol Clin Pract 2019; 9:539-541. 

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