Work

Case report: Vestibular paroxysmia: A diagnosis and treatment enigma

Year: 2025

Type: article

Abstract: Objective Patient: A 36-year-old female presented with a two-year history of persistent daily dizziness and positional vertigo. Each vertigo episode lasted less than one minute, occurring more than 20 times per day. Initially, she presented with bilateral tinnitus, which had reduced in intensity over time. Pure tone audiometry (PTA) showed bilateral mild sensorineural hearing loss. Both the Romberg and Fukuda tests were positive, with the patient falling to the right. She was swaying even with her eyes open. Ocular vestibular evoked myogenic potential (oVEMP) revealed right utricle dysfunction. Magnetic Resonance Imaging (MRI) of the brain and internal acoustic meatus (IAM) demonstrated a left Type I anterior inferior cerebellar artery (AICA) vascular loop and a right Type II AICA vascular loop. Her symptoms did not improve with betahistine Intervention She was started empirically on gabapentin, as carbamazepine was contraindicated due to the presence of the HLA-B*1502 gene Outcome measure Vertigo symptom scale has improved markedly from 42 to 25 Conclusion VP is a rare, debilitating condition that may greatly reduce the quality of life and predisposes the sufferers to anxiety disorder. Due to its rarity, the diagnosis often missed. Although it is a diagnosis of exclusion, one must be aware of the possible diagnosis and adopt systemic approach to manage this case.

Source: Otolaryngology Case Reports

DOI: 10.1016/j.xocr.2025.100674

Authors: WN Wan Mansor, N.D. Hashim, A. Reduzan, A. Abdullah, R. Salim

Institutions: National University of Malaysia, Hospital Sultanah Nur Zahirah, Hospital Universiti Sains Malaysia

Language: English

Topic: Vestibular and auditory disorders

Subfield: Neurology

Field: Neuroscience

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,110