ZWIĄZEK MIĘDZY SZYJNYMI I OCZNYMI MIOGENNYMI PRZEDSIONKOWYMI POTENCJAŁAMI WYWOŁANYMI A OBJAWAMI Z PNIA MÓZGU I ZMIANAMI WIDOCZNYMI W MRI U PACJENTÓW ZE STWARDNIENIEM ROZSIANYM

Abstract

BackgroundIn multiple sclerosis (MS), even in the presence of clinical brainstem symptoms, the brainstem does not always show gross lesions on magnetic resonance imaging (MRI). However, MS may impair vestibular-evoked myogenic potential (VEMP) responses.Material and methodsThis study included 70 participants, 40 who were MS patients and 30 healthy adult volunteers as controls. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cervical VEMP (cVEMP), and ocular VEMP (oVEMP).ResultsOf the 40 MS patients, 37.5% had abnormal cVEMP and 67.5% had abnormal oVEMP. Some 23% of the 21 MS patients without brainstemlesions on MRI had abnormal cVEMP and oVEMP, including 69% of those who had vertigo. MS patients with brainstem lesions on MRI had significantly greater oVEMP latency than patients without similar MRI findings.ConclusionsMS patients showed dysfunction in the vestibulo-ocular and vestibulo-spinal reflexes. This dysfunction is reflected in impaired oVEMP and cVEMP respectively despite the absence of structural brainstem abnormalities. Thus, VEMP, especially oVEMP, can be used as an early indicator of brainstem involvement in MS before radiological signs appear on MRI.