Vestibular paroxysmia is a somewhat controversial entity, and some physicians doubt its existence. In my experience, I believe that it a real disorder and responds very well to treatment.

Vestibular paroxysmia is due to neuro-vascular cross-compression. A blood vessel comes in contact with the vestibulo-cochlear nerve, and the pressure and pulsations lead to an erosion of the myelin (insulation) covering of the nerve. As a result, the nerve “short-circuits” episodically. The symptoms of this condition include short bursts of vertigo that occur spontaneously (without warning). These last less than a minute, and may be associated with hearing symptoms (muffled hearing and/or ringing). The frequency of these bursts of vertigo varies from person to person. Some may experience multiple episodes per day, while some experience fewer episodes. A brain MRI (IAC protocol) can help reveal the vascular compression of the vestibulo-cochlear nerve.


Treatment with an antiepileptic medication like carbamazepine is very effective for this condition. There are some potential adverse effects associated with carbamazepine, and its use should be monitored by a physician.