Evaluation of Cervical Vestibular Evoked Myogenic Potentials in Patients with Migraine.

Abstract

Objective: Recent studies have indicated that the brain stem may contribute in the pathogenesis of migraine through different mechanisms. In addition to being used mainly in otologic diseases, vestibular evoked myogenic potentials (VEMP) testing is also used in neurological diseases affecting the brain stem such as stroke and multipl sclerosis in the literature. Studies involving VEMP testing in patients with migraine are novel and few in number. The purpose of this study was to evaluate whether VEMP values in patients with migraine provide additional information regarding the pathogenesis. Methods: This study included 52 patients with migraine and 52 control subjects. In both patients and controls, VEMP examination was performed using click stimuli, and all responses were recorded for both portions of the sternocleidomastoid muscle. Latency, amplitude and threshold values of the P1-N1 wave were compared between the two groups. Results: The amplitude of the left p1 was 4.47±3.52 μv in patients and 6.15±4.79 μv in the controls, and the difference was statistically significant. On the left, the average difference in the P1-N1 amplitude was 9.04±6.13 μv in patients and 12.03±7.79 μv in the controls; this difference was also statistically significant. Conclusion:The available studies on the pathophysiology of migraine show that the brain stem is particularly affected at the upper part. However, VEMP testing is mainly used for the assessment of the neuronal pathway starting from the saccula-macula and finishing at the sternocleidomastoid muscle in the lower brain stem. In this study, the only significant differences in amplitude were found in left-P1 and P1-N1. The results of our study show that in patients with migraine, neuroanatomical structures in the lower brain stem can be asymmetrically affected. (Turkish Journal of Neurology 2013; 19:134-138) Key Words: Migraine, cervical vestibular evoked myogenic potentials, pathogenesis, brain stem Özet Amaç: Tarihsel olarak yeni çalışmalar, migren patogenezinde beyin sapının farklı mekanizmalarla rolü olabileceğine dikkat çekmektedir. Vestibüler Uyarılmış Miyojenik Potansiyeller (VEMP) başlıca otolojik hastalıklarda kullanılmış olmakla birlikte özellikle inme ve multipl skleroz gibi beyin sapını etkileyen nörolojik hastalıklarda da yapılmış çalışmalar literatürde mevcuttur. Migrenli hastalarda VEMP'le ilgili çalışmalar oldukça yeni tarihli ve az sayıdadır. Bu çalışmada migrenli hastalarda VEMP incelemesi yapılarak VEMP değerlerinin bu hastalarda patogenezle ilgili ek bir bilgi sağlayıp sağlamayacağının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 52 migren hastası ve 52 kontrol alındı. Migrenli hastalarda ve kontrollerin hepsinde klik uyarı ile yapılan VEMP incelemesinde her iki sternokleidomastoid kasından yanıtlar kaydedildi. P1-N1 dalgasının latans, amplitüd ve eşik değerleri ayrıca taraflar arasındaki farklar kaydedildi. Bulgular: Migrenli hastalarda sol P1 amplitüdü 4,47±3,52 μv, kontrol grubunda ise 6,15±4,79 μv idi ve aradaki fark istatistiksel ola...