# Sodium Channel Blockers for Vestibular Paroxysmia in Children

## TL;DR

This paper reviews the use of sodium channel blockers for treating vestibular paroxysmia in children, highlighting early evidence of their effectiveness.

## Contribution

The paper provides guidance on diagnosing and treating VP in children using sodium channel blockers, based on limited case reports.

## Key findings

- Oxcarbazepine and carbamazepine are the only sodium channel blockers used in children with VP.
- Efficacy was observed within one week at specific dosing ranges for both drugs.
- Only five case reports or small series were found, indicating a need for more research.

## Abstract

Background/Objectives: As vestibular paroxysmia (VP) has recently been described in children, with an incidence of up to 4% of vertigo, and a promising therapeutic response to sodium-channel-blocking drugs has also been reported, the aim of this paper is to review the available literature on this topic and to provide the best possible guidance for diagnosis and treatment. Methods: PubMed, Medline, Cochrane, and Crossref databases were searched, and all studies on VP in children and sodium channel blockers were selected. Results: Only five articles reporting small case series or single case reports were identified. To date, oxcarbazepine (OXC) and carbamazepine (CBZ) are the only two molecules prescribed. The recommended doses were 300 to 360 mg/day and 50 to 200 mg/day for OXC and CBZ, respectively, for a total duration of 6 weeks. Fast efficacy (one week) was reported. Conclusions: VP has been identified in pediatric patients and appears to respond to sodium channel blockers in a manner similar to adults. Only a limited number of cases have been reported to date; thus, there is a need to raise awareness about this treatable cause of episodic vertigo in children.