Dataset Information

Vestibular paroxysmia caused by contralateral tortuous vertebral artery : A case report

ABSTRACT: Abstract

Rationale:

Vestibular paroxysmia (VP) is characterized by spontaneous, recurrent, short, paroxysmal attacks of vertigo with or without tinnitus.

Patient concerns:

We report a case of paroxysmal recurrent vertigo accompanying clicking tinnitus on the left side in a 61-year-old patient. He had undergone microvascular decompression to treat the left-side hemifacial spasm 6 years prior. The patient first developed vertigo attacks about 3 years after microvascular decompression, and the attacks increased in frequency over the last 4 months. Video-nystagmography revealed a background right-beating nystagmus which was reversed every 55 seconds, to left-beating nystagmus for 17 seconds.

Diagnosis:

Brain magnetic resonance imaging and angiography demonstrated a compression of the cisternal segment of the left vestibulocochlear nerve between the tortuous right vertebral artery and the posterior wall of the left porus acusticus internus.

Interventions and outcomes:

Under the diagnosis of VP, 300 mg oxcarbazepine was administered daily, which relieved the symptoms dramatically.

Lesson:

The neurovascular cross-compression of the vestibulocochlear nerve by the contralateral vertebral artery tortuosity can cause VP. Periodic paroxysms of right-beating nystagmus accompanying the left-side tinnitus during vertigo attacks in our patient can be explained by secondary central hyperactivity in both vestibular and cochlear nuclei following long-standing neurovascular cross-compression.

SUBMITTER: Choi J

PROVIDER: S-EPMC8589239 | biostudies-literature |

REPOSITORIES: biostudies-literature

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