Assessment of cervical and ocular vestibular evoked myogenic potentials in migraine patients

Doaa Elmoazen,Dalia Ghanem,Jaidaa Mekky,Hesham Kozou

doi:10.1186/s43163-020-00017-1

Abstract

BackgroundPatients suffering from vestibular migraine (VM) are known to have various vestibular test abnormalities interictally and ictally. Recently, vestibular evoked myogenic potentials (VEMPs) have become accepted as a valid method for otolith function assessment. Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Since migraineurs with no accompanying vestibular symptoms might exhibit subclinical vestibular dysfunction, we investigated vestibular function using ocular and cervical VEMPs in migraine patients. The aim was to study cervical VEMP and occular VEMP in migraineurs with and without vestibular symptoms interictally.ResultsMigraine and VM patients showed significantly longer P13 latency of cVEMP compared to controls. A statistically significant cVEMP interaural P13 latency difference was found in VM compared to healthy controls. Cervical VEMP N23 latency, peak-to-peak amplitude, interaural N23 latency, and amplitude asymmetric ratio did not show any significant difference in migraine and VM patients compared to healthy controls as well as no significant difference across the three groups regarding oVEMP parameters.ConclusionsAbnormal interictal cVEMP results in migraineurs might indicate subclinical vestibulo-collic pathway dysfunction.

Highlights

Patients suffering from vestibular migraine (VM) are known to have various vestibular test abnormalities interictally and ictally
Migraine and migraine-associated vertigo (MAV) patients did not show significant differences compared to each other regarding Cervical vestibular evoked myogenic potentials (VEMPs) (cVEMP) and ocular VEMP (oVEMP) suggesting that vestibular insult is an integral part in the migraine pathophysiology
Migraine and MAV patients, who had abnormally delayed P13 latency compared to healthy controls, are suggested to have subclinical vestibular dysfunction in the vestibulo-collic pathway

Summary

Introduction

Patients suffering from vestibular migraine (VM) are known to have various vestibular test abnormalities interictally and ictally. Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Since migraineurs with no accompanying vestibular symptoms might exhibit subclinical vestibular dysfunction, we investigated vestibular function using ocular and cervical VEMPs in migraine patients. The aim was to study cervical VEMP and occular VEMP in migraineurs with and without vestibular symptoms interictally. Patients with migraine frequently have vestibular complaints, such as dizziness, unsteadiness, or head motion intolerance. 10% of the population has migraine headaches [1], and one third of these patients experience dizziness [2]. Vertigo is regularly associated with headache in 25 to 50% of migraine patients [3, 4].

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