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ORIGINAL ARTICLE
RELATION BETWEEN CERVICAL AND OCULAR VESTIBULAR EVOKED MYOGENIC POTENTIALS AND BRAINSTEM SYMPTOMS AND MRI LESIONS IN MULTIPLE SCLEROSIS PATIENTS
1
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., Egypt
2
Neurology Department, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt, Egypt
3
Audio-Vestibular Unit, Department of Otolaryngology,, Faculty of Medicine, Suez-Canal University, Egypt., Egypt
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Publication date: 2021-12-03
Corresponding author
Abeir Osman Dabbous
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., 5 Cairo University Street, 12211, Giza, Cairo, Egypt
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., 5 Cairo University Street, 12211, Giza, Cairo, Egypt
J Hear Sci 2021;11(3):57-68
KEYWORDS
multiple sclerosisvertigovestibulo-spinal reflexvestibulo-ocular reflexvestibular-evoked myogenic potential
TOPICS
ABSTRACT
Background:
In multiple sclerosis (MS), even in the presence of clinical brainstem symptoms, the brainstem does not always show gross lesions on magnetic resonance imaging (MRI). However, MS may impair vestibular-evoked myogenic potential (VEMP) responses.
Material and methods:
This study included 70 participants, 40 who were MS patients and 30 healthy adult volunteers as controls. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cervical VEMP (cVEMP), and ocular VEMP (oVEMP).
Results:
Of the 40 MS patients, 37.5% had abnormal cVEMP and 67.5% had abnormal oVEMP. Some 23% of the 21 MS patients without brainstemlesions on MRI had abnormal cVEMP and oVEMP, including 69% of those who had vertigo. MS patients with brainstem lesions on MRI had significantly greater oVEMP latency than patients without similar MRI findings.
Conclusions:
MS patients showed dysfunction in the vestibulo-ocular and vestibulo-spinal reflexes. This dysfunction is reflected in impaired oVEMP and cVEMP respectively despite the absence of structural brainstem abnormalities. Thus, VEMP, especially oVEMP, can be used as an early indicator of brainstem involvement in MS before radiological signs appear on MRI.
In multiple sclerosis (MS), even in the presence of clinical brainstem symptoms, the brainstem does not always show gross lesions on magnetic resonance imaging (MRI). However, MS may impair vestibular-evoked myogenic potential (VEMP) responses.
Material and methods:
This study included 70 participants, 40 who were MS patients and 30 healthy adult volunteers as controls. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cervical VEMP (cVEMP), and ocular VEMP (oVEMP).
Results:
Of the 40 MS patients, 37.5% had abnormal cVEMP and 67.5% had abnormal oVEMP. Some 23% of the 21 MS patients without brainstemlesions on MRI had abnormal cVEMP and oVEMP, including 69% of those who had vertigo. MS patients with brainstem lesions on MRI had significantly greater oVEMP latency than patients without similar MRI findings.
Conclusions:
MS patients showed dysfunction in the vestibulo-ocular and vestibulo-spinal reflexes. This dysfunction is reflected in impaired oVEMP and cVEMP respectively despite the absence of structural brainstem abnormalities. Thus, VEMP, especially oVEMP, can be used as an early indicator of brainstem involvement in MS before radiological signs appear on MRI.
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