Different results of vestibular examinations and blood flow in cases with transient vascular vertigo/dizziness with or without central nervous system symptoms

Abstract

Background The condition of vestibular dysfunction and blood flow in the vertebral artery (VA) in transient vascular vertigo/dizziness (TVV) is not well established. Objectives To clarify the pathophysiology of TVV, especially the difference between the isolation of vestibular symptoms. Materials and methods Ten TVV patients with central nervous system symptoms (TVVw) and 12 TVV patients without central nervous system symptoms (TVVo) underwent duplex color-coded ultrasonographic evaluation of VAs, caloric test, and cervical vestibular-evoked myogenic potential (cVEMP). Results The mean flow velocity (MV) ratio (peak MV of contralateral VA divided by target VA) was significantly higher in TVVw than in TVVo. There was no difference in the occurrence of canal paresis between TVVw and TVVo. Abnormal asymmetry ratios (ARs) of cVEMP were observed only in TVVo cases (6 of 12 cases), revealing a statistically significant difference in the number of cases between TVVw and TVVo. Conclusions and significance Measuring VAs using duplex color-coded ultrasonography and cVEMP may help evaluate TVV. Different results of MV ratio and cVEMP between TVV cases with or without central nervous system symptoms may indicate differences in the pathophysiology between TVVw and TVVo.