前庭性発作症5例・疑い1例の治療経験

Experience with five cases of vestibular paroxysmia and one probable vestibular paroxysmia

はじめに

　2016年にBarany Societyにより診断基準（表1）^1）が作成された前庭性発作症（vestibular paroxysmia：VP）は，短時間のめまいを反復する疾患であり，従来の第Ⅷ脳神経血管圧迫症候群に類似する。第Ⅷ脳神経血管圧迫症候群は，診断基準はないが，ビリビリやバリバリと表現される特徴的な短時間の耳鳴やそれに伴うめまいが起こり，頭部MRIで血管による第Ⅷ脳神経の圧排が認められる。今回，前庭性発作症5例と疑い1例を経験したので報告する。

　Vestibular paroxysmia is characterized by recurrent short episodes of dizziness. The diagnostic criteria resemble those of conventional neurovascular compression syndrome affecting the eight cranial nerves, although head MRI is not mandatory. The treatment of vestibular paroxysmia involves carbamazepine and oxcarbazepine. Herein, we present our experience with five cases of vestibular paroxysmia and one case of probable vestibular paroxysmia. Symptomatic improvement was observed in five patients treated with carbamazepine（200 mg/day）, while one eventually required an increased dose of carbamazepine（600 mg/day）. In one patient with renal dysfunction, carbamazepine could not be administered; however, her symptoms improved with yokukansan.