Bithermal caloric test results and vestibular evoked myogenic potentials in patients with vestibular migraine

Abstract

Objectives: The aim of this study was to study the ocular vestibular evoked myogenic potentials, cervical vestibular evoked myogenic potentials, and bithermal caloric test results in subjects with vestibular migraine and to discover whether they are correlated. Study design: The study group included 50 patients with vestibular migraine (32 females, 18 males), with age range 18–60 years (38 ± 12.2). The control group included 60 healthy volunteers of matched age and gender distribution. Audiovestibular evaluation in the form of pure tone audiometry, middle ear immittance, ocular and cervical vestibular evoked myogenic potentials, and a bithermal caloric test were performed after at least three days from the last migraine or vertiginous episode; none of the study group was kept on prophylactic treatment for migraine. Results: Normal vestibular evoked myogenic potentials and caloric responses were reported in the entire control group and 12 subjects (24%) of the study group. Unilateral canal paresis was reported in 19 subjects in the study group. Abnormal ocular and cervical vestibular evoked myogenic potentials were registered in 27 and 30 subjects of the study group, respectively; abnormal vestibular evoked myogenic potentials (either ocular or cervical) were registered in 38 subjects. In this study 80 abnormal ocular and cervical vestibular evoked myogenic potentials were registered in the study group; there were 14 traces showing delayed peak latency and 66 traces showing absent responses. There were positive correlations between the incidence of canal paresis and both abnormal ocular and cervical vestibular evoked myogenic potentials in the ipsilateral and the contralateral ears. Conclusions: The patients with vestibular migraine showed a significantly higher prevalence of abnormal bithermal caloric test results and ocular and cervical vestibular evoked myogenic potentials. Significant canal paresis is associated with more pronounced abnormal vestibular evoked myogenic potentials