Role of cervical vestibular-evoked myogenic potentials testing in vestibular migraine

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BackgroundVestibular dysfunction has been long described in patients with migraine; this relation has been addressed as vestibular migraine. The pathophysiology as well as the peripheral or central localization of this deficit is unclear. Cervical vestibular evoked myogenic potential (cVEMP) is a validated method to test saccular function and vestibulocollic pathway. ObjectivesThe current work was designed to assess the characteristics of cVEMP response in patients with vestibular migraine and compare them with the results of healthy controls, and to find out if the cVEMP could be useful as a complementary tool for testing vestibular function in vestibular migraine. MethodsTwenty five patients with definite vestibular migraine were involved as a study group. Twenty healthy volunteers of comparable age and sex were taken as a control group. The amplitude and latency of cVEMP were measured. Electronystagmography (ENG) test battery including caloric testing was done. ResultsOur study demonstrated significant reduction in cVEMP amplitudes, and more frequently absent response in patients with vestibular migraine compared to healthy controls. There was no correlation between cVEMP amplitudes and caloric testing. ENG tests showed peripheral vestibular lesion in 36% of patients, central lesion in 16%, mixed lesion in 4%. ConclusioncVEMP is a useful complementary tool for testing vestibular function in vestibular migraine. Reduced cVEMP amplitude or absent response were the most frequent features in vestibular migraine. The saccule and or the sacculo-collic pathway are affected in vestibular migraine, with more tendencies for peripheral vestibular dysfunction in our patient group.