Vestibular Evoked Myogenic Potential in Multiple Sclerosis (MS)

Background: Involvement of the brainstem in multiple sclerosis [MS] has significant implications on the disease course and can be presented with different symptoms. There are many tests able to detect brain-stem involvement in MS with various degrees of success. Aim of the work: To study the changes in vestibular evoked myogenic potential [VEMP], in patients with MS, and to detect its sensitivity for detection of the brain-stem lesions previously diagnosed with magnetic resonance imaging [MRI] in MS patients. Patients and Methods: Sixty participants had been enrolled and divided into two groups: 30 healthy subjects [Control group] and 30 MS patients [Study group]. Both groups had been subjected to otological examinations, pure tone audiometry, acoustic impedance, cervical vestibular evoked myogenic potential [cVEMP], ocular vestibular evoked myogenic potential [oVEMP] and MRI.  Results: In MS group, oVEMP mean latencies of n1 and p1 and cVEMP mean p13 and n23 latencies were significantly prolonged. In addition, 14 MS patients [46.7%] had brainstem lesions as confirmed by MRI. Finally, oVEMP test had higher sensitivity than the cVEMP in prediction of brainstem lesions. Conclusion: oVEMP seems to be useful and more sensitive than cVEMP as an adjunct test in the evaluation of brain-stem dysfunction in MS patients.