추골동맥에 의해 발생한 전정발작 1예 = A Case of Vestibular Paroxysmia Offended by Vertebral Artery

다국어 초록 (Multilingual Abstract)

Vestibular paroxysmia, which is caused by neurovascular cross-compression of the eighth cranial nerve, is characterized by recurrent vertiginous spells and other audiologic symptoms such as tinnitus, aural fullness and hearing impairment. Magnetic resonance image may show the eighth cranial nerve compression by vessels in the posterior fossa such as the anterior-inferior cerebellar, posterior-inferior cerebellar, basilar, or vertebral arteries. Medical therapy including carbamazepine, phenytoin or gabapentin and microvascular decompression of the eighth cranial nerve can be contemplated. Here, we report of a 51 year-old man who presented with recurrent vertigo attacks and tinnitus. His symptoms were aggravated by positional change. Videonystagmography and auditory brainstem response showed abnormal results. Magnetic resonance image showed the eighth cranial nerve compression caused by the vascular loop. The offending vessel was revealed as vertebral artery. He was treated with carbamazepine and showed no recurrent symptoms. We report this rare case with a review of the relevant literatures.

참고문헌 (Reference)

1 문석균, "전정신경에 대한 혈관성 신경압박증후군에서 미세혈관감압술의 효과" 대한이비인후과학회 51 (51): 783-789, 2008

2 Hüner K, "Vestibular paroxysmia: diagnostic features and medical treatment" 71 (71): 1006-1014, 2008

3 Ohashi N, "Vascular cross-compression of the VIIth and VIIIth cranial nerves" 106 (106): 436-439, 1992

4 Bergsneider M, "Vascular compression syndrome of the vestibular nerve: a critical analysis" 112 (112): 118-124, 1995

5 Brandt T, "VIIIth nerve vascular compression syndrome: vestibular paroxysmia" 3 (3): 565-575, 1994

6 Jannetta PJ., "Outcome after microvascular decompression for typical trigeminal neuralgia, hemifacial spasm, tinnitus, disabling positional vertigo, and glossopharyngeal neuralgia (honored guest lecture)" 44 : 331-383, 1997

7 Jannetta PJ, "Neurovascular cross-compression in patients with hyperactive dysfunction symptoms of the eighth cranial nerve" 26 : 467-469, 1975

8 Brackmann DE, "Microvascular decompression of the vestibulocochlear nerve for disabling positional vertigo: the House Ear Clinic experience" 22 (22): 882-887, 2001

9 Okamura T, "Microvascular decompression for cochlear symptoms" 93 (93): 421-426, 2000

10 Sakaki T, "Microsurgical treatment of patients with vestibular and cochlear symptoms" 27 (27): 141-146, 1987

11 Jannetta PJ, "Disabling positional vertigo" 310 (310): 1700-1705, 1984

12 Møller MB, "Diagnosis and surgical treatment of disabling positional vertigo" 64 (64): 21-28, 1986

13 Gardner WJ., "Cross talk--the paradoxical transmission of a nerve impulse" 14 (14): 149-156, 1966

14 Schwaber MK, "Cochleovestibular nerve compression syndrome. I. Clinical features and audiovestibular findings" 102 (102): 1020-1029, 1992

15 Lee JK, "A case of neurovascular cross-compression of the eighth cranial nerve representing longstanding uncompensated vestibular hypofunction" 8 (8): 137-141, 2009