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Vestibular paroxysmia: Diagnostic criteria.

  • Strupp M Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital Munich, University of Munich, Germany.
  • Lopez-Escamez JA Otology and Neurotology Group CTS495, Department of Genomic Medicine - Centre for Genomics and Oncology Research - Pfizer/Universidad de Granada/Junta de Andalucía (GENyO), PTS, Granada and Department of Otolaryngology, University Hospital Granada, Spain.
  • Kim JS Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, South Korea.
  • Straumann D Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland.
  • Jen JC Department of Neurology & Neurobiology, University of California, Los Angeles, CA, USA.
  • Carey J Department of Otorhinolaryngology, Johns Hopkins University School of Medicine, Baltimore, USA.
  • Bisdorff A Department of Neurology, Centre Hospitalier Emile Mayrisch, Esch, Luxemburg.
  • Brandt T Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital Munich, University of Munich, Germany.
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  • 2017-03-07
Published in:
  • Journal of vestibular research : equilibrium & orientation. - 2016
ICVD
Vertigo
attacks
dizziness
neurovascular compression
Benign Paroxysmal Positional Vertigo
Carbamazepine
Diagnosis, Differential
Female
Head Movements
Humans
Magnetic Resonance Imaging
Male
Otologic Surgical Procedures
Oxcarbazepine
Prevalence
Vertigo
Vestibular Diseases
Vestibular Function Tests
Vestibulocochlear Nerve
English This paper describes the diagnostic criteria for vestibular paroxysmia (VP) as defined by the Classification Committee of the Bárány Society. The diagnosis of VP is mainly based on the patient history and requires: A) at least ten attacks of spontaneous spinning or non-spinning vertigo; B) duration less than 1 minute; C) stereotyped phenomenology in a particular patient; D) response to a treatment with carbamazepine/oxcarbazepine; and F) not better accounted for by another diagnosis. Probable VP is defined as follows: A) at least five attacks of spinning or non-spinning vertigo; B) duration less than 5 minutes; C) spontaneous occurrence or provoked by certain head-movements; D) stereotyped phenomenology in a particular patient; E) not better accounted for by another diagnosis.Ephaptic discharges in the proximal part of the 8th cranial nerve, which is covered by oligodendrocytes, are the assumed mechanism. Important differential diagnoses are Menière's disease, vestibular migraine, benign paroxysmal positional vertigo, epileptic vestibular aura, paroxysmal brainstem attacks (in multiple sclerosis or after brainstem stroke), superior canal dehiscence syndrome, perilymph fistula, transient ischemic attacks and panic attacks. Current areas of uncertainty in the diagnosis of VP are: a) MRI findings of vascular compression which are not diagnostic of the disease or predictive for the affected side because they are also observed in about 30% of healthy asymptomatic subjects; and b) response to treatment with carbamazepine/oxcarbazepine supports the diagnosis but there are so far no randomized controlled trials for treatment of VP.
Language
  • English
Open access status
bronze
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Persistent URL
https://folia.unifr.ch/global/documents/11596
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