Ocular and Cervical Vestibular Evoked Myogenic Potentials in Patients With Multiple Sclerosis

Objectives: The aim of this study was to evaluate latencies and corrected p13-n23 cervical vestibular evoked myogenic potentials (cVEMP) and n10-p13 ocular vestibular evoked myogenic potentials (oVEMP) amplitudes in patients with relapsing remitting multiple sclerosis (MS). Methods: This was a prospective, case-control study. Thirty patients with MS and 15 healthy controls were included. Cervical vestibular evoked myogenic potentials and oVEMP in response to acoustic clicks of 1 ms duration at the intensity of 130 dB SPL and the stimulation frequency of 1 Hz were studied. Signals were divided in segments of 120 ms duration (20 ms before the stimulus and 100 ms after the stimulus) and averaged. Results: In MS group, there was significant latencies prolongation of all sternocleidomastoid responses (p13 and n23) and n10 response of the ocular muscles. The sternocleidomastoid p13-n23 normalized amplitude was significantly higher in MS patients. Prolonged latencies were found in 57% and conduction block in 7% of patients in at least one sternocleidomastoid response in the MS group. Prolonged latencies were found in 30% and conduction block in 40% of patients in at least one ocular response in the MS group. When cVEMP and oVEMP are combined, 80% had pathological finding. When correlating brainstem clinical, brainstem MRI, and cVEMP findings, there was no statistical significance (brainstem clinical vs. cVEMP P = 0.1; brainstem MRI vs. cVEMP P = 0.82). When correlating brainstem clinical, brainstem MRI and oVEMP findings, there was a statistical significant correlation between brainstem clinical versus oVEMP, P = 0.02, whereas there was no statistical significance between brainstem MRI versus oVEMP (P = 0.38). Conclusions: Combination of cVEMP and oVEMP in MS patients allows better estimation of brainstem lesions.