Gabapentin responsive audiovestibular paroxysmia.

Trigeminal neuralgia and hemifacial spasm are well-documented vascular compression syndromes involving the 5th and 7th cranial nerves. Drugs that stabilize the irritated nerves and vascular decompression surgery are accepted treatments. By contrast, the diagnosis and treatment of a comparable syndrome involving the 8th cranial nerve is controversial. We describe two patients with brief, spontaneous, recurrent attacks of tinnitus and vertigo that responded to low dose gabapentin and we argue that this clinical presentation represents the prototypical 8th nerve vascular compression syndrome.