Table 2.

Modified diagnostic criteria for neurovascular compression of the cochlear nerve (NVC-C).

Consider diagnosis when paroxysmal, short-lasting tinnitus observed.

a. Staccato character (tapping, clicking, or crackling in nature)

b. Typically, unilateral, but bilateral involvement can also be seen.

1. Responsiveness to low-dose carbamazepine (200–400 mg/day)

a. Prompt tinnitus improvement (within 2 weeks)

b. When the medication is stopped, the symptoms may recur.

2. Associated ipsilateral symptoms

a. Paroxysmal vertiginous spells

b. Hemifacial spasms

3. Supportive criteria – positive auditory evoked potential using Moller’s criteria41

a. Commonly normal before 2 years of symptoms

b. Ipsilateral interpeak latency I-III ≥ 2.3 ms

c. Reduced peak II amplitude <33%

4. Exclusionary criteria for NVC-C

a. Tumor of the cerebellopontine angle or internal auditory canal on MRI

b. Demyelination disease on cerebral MRI

5. Positive MRI for vascular conflict have no diagnostic specificity.