title: 7-Tesla MRI demonstrates absence of structural lesions in patients with vestibular paroxysmia.
abstract: Vestibular parxoysmia (VP) is a rare vestibular disorder. A neurovascular cross-compression (NVCC) between the vestibulochochlear nerve and an artery seems to be responsible for short attacks of vertigo in this entity. An NVCC can be seen in up to every fourth subject. The significance of these findings is not clear, as not all subjects suffer from symptoms. The aim of the present study was to assess possible structural lesions of the vestibulocochlear nerve by means of high field magnetic resonance imaging (MRI), and whether high field MRI may help to differentiate symptomatic from asymptomatic subjects. 7 Tesla MRI was performed in six patients with VP and confirmed NVCC seen on 1.5 and 3.0 MRI. No structural abnormalities were detected in any of the patients in 7 Tesla MRI. These findings imply that high field MRI does not help to differentiate between symptomatic and asymptomatic NVCC and that the symptoms of VP are not caused by structural nerve lesions. This supports the hypothesis that the nystagmus associated with VP has to be conceived pathophysiologically as an excitatory vestibular phenomenon, being not related to vestibular hypofunction. 7 Tesla MRI outperforms conventional MRI in image resolution and may be useful in vestibular disorders.
authors.affiliation: Department of Neurology, Medical University of Vienna Vienna, Austria.
authors.forename: Paulus S
authors.initials: PS
authors.lastname: Rommer
authors.affiliation: Department of Neurology, Medical University of Vienna Vienna, Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Wiest
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Centre of Excellence, High-Field MR, Medical University of Vienna Vienna, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Kronnerwetter
authors.affiliation: Department of Neurology, Medical University of Vienna Vienna, Austria.
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Zach
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Rudolfstiftung Tertiary Teaching Hospital Vienna, Austria.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Loader
authors.affiliation: Rehabilitation Center Meidling Vienna, Austria.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Elwischger
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Centre of Excellence, High-Field MR, Medical University of Vienna Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Trattnig
keywords: anatomy; clinical neurology; high field MRI; nerve compression; neuro imaging; neuroscience; vestibular paroxysmia