ORIGINAL ARTICLE
CERVICAL AND OCULAR VESTIBULAR EVOKED MYOGENIC POTENTIALS IN MIGRAINE PATIENTS
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1
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., Egypt
2
Neurology Department,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., Egypt
3
Audio-vestibular Unit, Department of Otolaryngology,, Suez-Canal University, Egypt, Egypt
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Publication date: 2021-08-31
Corresponding author
Abeir Osman Dabbous
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., Cairo University, 12211, Cairo, Egypt
J Hear Sci 2021;11(2):59-68
KEYWORDS
TOPICS
ABSTRACT
Background:
In migraine, there is no anatomical correlate of vertigo and no structural abnormality is evident in conventional imaging. Cervical vestibular-evoked myogenic potential (cVEMP) is an uncrossed inhibitory vestibulo-spinal reflex (VSR), while ocular VEMP (oVEMP) represents a crossed excitatory vestibulo-ocular reflex (VOR).
Objective:
This study aims at functional evaluation of the findings of cVEMP and oVEMP in migraine patients.
Material and methods:
This was a cross-sectional case-control study that included 20 migraine patients as the case group and 30 healthy adult subjects as a control group. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cVEMP, oVEMP, and posturography tests.
Results:
35% of migraine patients showed delayed cVEMP latency and 40% showed abnormal oVEMP in the form of statistically significant delayed right oVEMP P1 (p = 0.050) and left oVEMP N1 latency (p = 0.038) compared with controls. cVEMP parameters were not correlated to posturography results. The majority of migraine patients (70%) had normal equilibrium pattern and normal sensory analyses ratios (65%). Only 30% had vestibular dysfunction.
Conclusions:
VSR and VOR are affected in migraine patients. We recommend the use of cVEMP and oVEMP in migraine patients for functional assessment of brainstem pathways.
REFERENCES (32)
1.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 2018; 38(1): 1–211.
2.
Lempert T, von Brevern M. Vestibular Migraine. Neurol Clin, 2019; 37(4): 695–706.
3.
Iwasaki S, Smulders Y, Burgess A, McGarvie L, MacDougall H, Halmagyi G. Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects. Clin Neurophysiol, 2008; 119(9): 2135–47.
4.
Curthoys IS. A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound, vibration and galvanic stimuli. Clin Neurophysiol 2010; (121): 132–44.
5.
Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol, 2010; 121: 636–51.
6.
Welgampola MS and Colebatch JG. Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology, 2005; 24: 1682–8.
7.
Todd NPM, Rosengren SM, Aw ST, Colebatch JG. Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol, 2007; 118: 381–90.
8.
Pang MY, Lam FM, Wong GH, Au IH, Chow DL. Balance performance in headshake computerized dynamic posturography: aging effects and test–retest reliability. Phys Ther, 2011; 91(2): 246–53.
9.
Headache Classification Committee of the International Headache Society (IHS): The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 2013 Jul; 33(9): 629–808.
10.
Alsanosi A. Adaptation of the dizziness handicap inventory for use in the Arab population. Neurosciences, 2012; 17(2): 139–44.
11.
Jacobson G, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg, 1990; 116: 424–7.
12.
Shalaby NM, Ramzy GM, Nada MAF, Hussein AF, El-Fayomy NM, El-Minawi MS, Dabbous AO, El-Dessouky T. Assessment of the vestibulo-spinal reflex in migraine patients. Egypt J Neurol Psychiat Neurosurg, 2010; 47(1): 67–74.
13.
Kim CH, Jang MU, Choi HC, Sohn JH. Subclinical vestibular dysfunction in migraine patients: a preliminary study of ocular and rectified cervical vestibular evoked myogenic potentials. J Headache Pain, 2015; 16: 93.
14.
Khalil LH, Hazzaa NM, Nour AA. Vestibular migraine: a correlation study between clinical findings and vestibular evoked myogenic potentials (VEMPs). Egypt J Ear Nose Throat Allied Sci, 2016; 17: 11–16.
15.
Kang WS, Lee SH, Yang CJ, Ahn JH, Chung JW, Park HJ. Vestibular function tests for vestibular migraine: clinical implication of video head impulse and caloric tests. Front Neurol, 2016; 7: 166.
16.
Baier B, Stieber N, Dieterich M. Vestibular-evoked myogenic potentials in vestibular migraine. J Neurol, 2009; 256(9): 1447–54.
17.
Salviza M, Yucec T, Acarb H, Taylana I, Yuceanta GA, Karatasa A. Diagnostic value of vestibular-evoked myogenic potentials in Ménière’s disease and vestibular migraine. J Vestib Res, 2015; 25: 261–6.
18.
Inoue A, Egami N, Fujimoto C, Kinoshita M, Yamasoba T, Iwasaki S. Vestibular evoked myogenic potentials in vestibular migraine: do they help differentiating from Menière’s disease? Ann Otol Rhinol Laryngol, 2016; 125(11): 931–7.
19.
Makowiec KF, Piker EG, Jacobson GP, Ramadan NM, Roberts RA. Ocular and cervical vestibular evoked myogenic potentials in patients with vestibular migraine. Otol Neurotol, 2018; 39: 561–7.
20.
Zaleski A, Bogle J, Starling A, Zapala DA, Davis L, Wester M, Cevette M. Vestibular evoked myogenic potentials in patients with vestibular migraine. Otol Neurotol, 2015; 36: 295–302.
21.
Jung JH, Yoo MH, Song CI, Lee JR, Park HJ. Prognostic significance of vestibulospinal abnormalities in patients with vestibular migraine. Otol Neurotol, 2015; 36(2): 282–8.
22.
Sürmeli M, Sürmeli R, Deveci I, Önder S, Yalçın AD, Oysu Ç. Correlation between cVEMP and ABR for the evaluation of vestibular migraine. J Int Adv Otol, 2016; 12: 326–31.
23.
Lipton, RB, Bigal ME, Ashina S, Burstein R, Silberstein S, Reed ML, Serrano D, Stewart WF. Cutaneous allodynia in the migraine population. Ann Neurol, 2008; 63(2): 148–58.
24.
Young WB. Allodynia as a complication of migraine: background and management. Curr Treat Options Neurol, 2009; 11(1): 3–9.
26.
Roceanu A, Allena M, de Pasqua V et al. Abnormalities of the vestibulo-collic reflex are similar in migraineurs with and without vertigo. Cephalalgia, 2008; 28: 988–90.
27.
Özdemir O, Akpınar CK, Küçüköner O, Mehel DM, Bedir A, Akgül G, Can E, Özgür A. Vestibular evoked myogenic potential (VEMP) results in migraine and migrainous vertigo. Acta Otolaryngol, 2020; 140(2): 140–43.
28.
Hong HR, Shim DB, Kim TS, Shim BS, Ahn JH, Chung JW, Yoon TH, Park HJ. Results of caloric and sensory organization testing of dynamic posturography in migrainous vertigo: comparison with Meniere’s disease and vestibular neuritis. Acta Otolaryngol, 2013; 133: 1236–41.
29.
Çelebisoy N, Gökçay F, Şirin H, Biçak N. Migrainous vertigo: clinical, oculographic and posturographic findings. Cephalalgia, 2008; 28: 72–7.
30.
Mallinson AI, Kuijpers ACM, Van Zwieten G, Kakal J, Mullings W, Longridge NS. Computerized dynamic posturography does not detect measured CVEMP and OVEMP abnormalities. Gait Posture, 2019; 67: 248–50.
31.
Agrawal Y, Zuniga G, Davalos-Bichara M, Schubert MC, Walston JD, Hughes J, Carey JP. Decline in semicircular canal and otolith function with age. Otol Neurotol, 2013; 33(5): 832–9.
32.
Yip CW, Strupp M. The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study. J Neurol, 2018; 265(5): 1210–18.