Vestibular Evoked Myogenic Potentials (VEMP) in patients with Multiple Sclerosis

Abstract

Background: multiple sclerosis (MS) is a chronic demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged and this damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms. Objective: this study aimed to assess cervical vestibular evoked myogenic potentials (cVEMP) in patient with multiple sclerosis and to demonstrate the value of cVEMP as a good method for the assessment of vestibulospinal tract in patients with MS. Patients and Methods: to achieve this target, we enrolled 50 subject: 30 patients diagnosed as MS in addition to 20 healthy control. The cVEMP response was evaluated for the presence of positive (p1) and negative (n1) peaks of the first biphasic wave complex; latency (p1 and n1 latency) and peak to peak amplitude. The bilateral otoscopy was normal in cases and controls, with no middle or outer ear disease that could bias the study results being found. The pure tone audiometry showed levels of hearing compatible with normal hearing in the 20 healthy subjects, with hearing thresholds that did not exceed 25 dB for any individual. Results: the present results showed that 60 % of MS patients had VEMP abnormalities (absent responses and/or prolonged latencies). In the present study, patients with absent VEMP wave were found to have significantly higher disease duration. In the present study, the absence of P13–N23 waves were more frequent in patients with greater EDSS score, and also absence of P13–N23 waves were more frequent in patients with MS with vestibular symptoms and greater disability. Conclusion: we can say that in patients with MS in which demyelination has extended to the vestibulospinal tract, there is going to be a prolongation of the p13 and n23 wave. In fact, this increase in the p13 and n23 latencies is clear in the patients with MS in comparison to the control group.