Response to treatment with carbamazepine or oxcarbazepine is a criterion for the diagnosis of vestibular paroxysmia (VP). In this report, we describe two suspected cases of VP based on their clinical symptoms and response to carbamazepine. Although these patients responded to carbamazepine, they did not meet the diagnostic criteria for VP. Therefore, based on our clinical findings from these cases, carbamazepine may be effective in treating patients with vertigo just as it is in patients with VP. In VP, carbamazepine regulates pathological neurotransmission by controlling sodium metabolism in the cerebellar pontine angle and inner ear canal. Additionally, it may be effective for treating conditions similar to VP, such as neurovascular compression syndrome and vertebrobasilar artery circulatory disorders. In the first case, the patient was a 70-year-old man who frequently presented with dizziness. An MRI of the head revealed vascular compression in the inner ear canal. The second case was that of a 59-year-old man who repeatedly had episodes of vertigo. Investigations, including MRI and MRA, showed a vertebral artery insufficiency. Both patients responded to carbamazepine but did not fully meet the diagnostic criteria for VP.
