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Subject Area

Otorhinolaryngology

Article Type

Original Study

Abstract

Objective To assess vestibular function in multiple-sclerosis (MS) patients using vestibular-evoked myogenic potential (VEMP) and videonystagmography and to evaluate the role of VEMP in the detection of brain stem dysfunction in MS patients. Background Vertigo and imbalance are the common symptoms of MS. Patients and methods This case–control study was carried out on 60 participants, divided into two groups: 30 normal participants not complaining from any dizzy symptoms and 30 MS patients fulfilling the criteria for definite MS. All participants in the study were submitted to audiological and vestibular assessment. Results There was a statistically significant difference in the latency and amplitude of cervical VEMP (cVEMP) and ocular VEMP (oVEMP) between the control and the MS group (P < 0.001), 45% of the MS patients had cVEMP abnormalities, 50% had oVEMP abnormalities. Abnormal VEMP, either cVEMP or oVEMP, was reported in 60%. Abnormal videonystagmography results were reported in 53% of patients in the current study. There was a statistically significant relationship between VEMP abnormalities and higher frequency of attacks (P < 0.01), duration of MS (P < 0.001), Expanded Disability Status Scale (P < 0.01), and the presence of audiovestibular symptoms (P < 0.03). There was a statistically significant relationship between brain stem lesions in MRI and VEMP findings (P = 0.01 for cVEMP and P = 0.002 for oVEMP). Conclusion Vestibular abnormalities are frequently encountered in MS patients, VEMP abnormalities are associated with brain stem lesions in MRI. Abnormal VEMP may be reported in patients without brain stem affection in MRI.

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