E-ISSN 2602-4837
Evaluation of vestibular system using c-VEMP and o-VEMP in patients with relapsing-remitting multiple sclerosis [Tr-ENT]
Tr-ENT. 2019; 29(3): 119-125 | DOI: 10.5606/Tr-ENT.2019.51423

Evaluation of vestibular system using c-VEMP and o-VEMP in patients with relapsing-remitting multiple sclerosis

Belgin Tutar1, Güler Berkiten1, Ziya Salturk1, Ayca Baskadem Yilmazer1, Canan Emir2, Enis Ekincioğlu1, Yavuz Uyar1, Ömür Biltekin Tuna1
1Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences, Okmeydanı Training and Research Hospital, Istanbul Turkey
2Department of Neurology, University of Health Sciences, Okmeydanı Training and Research Hospital, Istanbul Turkey

INTRODUCTION: This study aims to evaluate the role of vestibular evoked myogenic potentials (VEMPS; the cervical VEMP [cVEMP] and the ocular VEMP [oVEMP]) in the vestibular system in patients with relapsing-remitting multiple sclerosis (RRMS).
METHODS: Between December 2016 and December 2017, a total of 42 ears of 21 RRMS patients (8 males, 13 females; mean age 41 years; range, 25 to 57 years) and 42 ears of 21 healthy controls (7 males, 14 females; mean age 44 years; range, 38 to 62 years) were included. All participants underwent neurological evaluation, brain magnetic resonance imaging (MRI), audiometry, tympanometry, and stapedial reflex testing. Their oVEMPs and cVEMPs were recorded.
RESULTS: For cVEMP testing, the mean P1 and N1 latencies of the left ears of RRMS patients were significantly higher compared to the controls. There was no significant difference between patients and controls in terms of the P1-N1 interval or mean amplitude of the left ear (p>0.05). The P1 and N1 latencies and the mean P1-N1 interval of the right ears of RRMS patients were significantly higher than the controls (p=0.019, p=0.001, p=0.004; p<0.05, respectively). There was no significant difference in the amplitudes or amplitude asymmetry ratios (AARs) of either ear between patients and controls (p>0.05 for all). The P1 and N1 latencies were prolonged in 13 (42%) of 42 RRMS ears and 27 ears (64%), respectively. For oVEMP testing, eight patients (19%) had no response in the oVemp test of the right ear (n=4) and left ear (n=4) of RRMS patients. There was no significant difference in P1 or N1 latencies or the P1-N1 interval, amplitude or AAR of right ears between the patients and controls (p>0.05 for all). The P1 and N1 latencies were prolonged in 26 (62%) of RRMS ears and 27 ears (64%), respectively.
DISCUSSION AND CONCLUSION: Based on our study results, VEMPs are useful for the evaluation of central vestibulopathies. The VEMP testing can diagnose brainstem lesions in RRMS patients quickly, easily, and safely without pain, although MRI shows no brainstem involvement. The VEMP testing is an electrophysiological test which can detect early stage pathologies of the vestibular system.

Keywords: Multiple sclerosis, vertigo, evoked potentials.

Belgin Tutar, Güler Berkiten, Ziya Salturk, Ayca Baskadem Yilmazer, Canan Emir, Enis Ekincioğlu, Yavuz Uyar, Ömür Biltekin Tuna. Evaluation of vestibular system using c-VEMP and o-VEMP in patients with relapsing-remitting multiple sclerosis. Tr-ENT. 2019; 29(3): 119-125

Corresponding Author: Belgin Tutar, Türkiye
LookUs & Online Makale