Audio-vestibular findings in Vestibular Paroxysmia

Abstract

Vestibular paroxysmia (VP) is attributed to neurovascular cross-compression due to vascular loops around the Vestibulocochlear nerve. The exact audio-vestibular profile of individuals with VP is uncertainly reported in literature. Thus, the study was aimed at reporting the results of audio-vestibular test battery in VP. A 37 year-old-female and a 30 year-old-male with tinnitus, giddiness, and positional vertigo underwent routine audiological testing, oto-acoustic emissions, auditory brainstem response, vestibular evoked myogenic potentials, and chochlear hydrops analysis masking procedure which produced normal results. The Dix-Hallpike maneuver revealed positional vertigo and nystagmus while symptoms such as oscillopsia and giddiness were reported during central vestibular tests. The magnetic resonance imaging (MRI) report revealed labyrinthine artery loops around the VII and VIII cranial nerves. We conclude that subtle symptoms like oscillopsia, giddiness, or vomiting sensation on central vestibular tests should be carefully noted to enhance the identification of VP using audio-vestibular tests battery and MRI should be done for all cases presenting with symptoms of non-fatigable positional vertigo.