Evaluation of cervical vestibular miogenic evoked potential and electrococleography in the diagnosis of vestibular migraine

TL;DR

This study explores how cervical vestibular-evoked myogenic potential and electrocochleography can help diagnose vestibular migraine, but finds no specific markers.

Contribution

The study evaluates cVEMP and ECoG as potential diagnostic tools for vestibular migraine, highlighting their limitations.

Findings

Vestibular migraine patients showed increased P1 and N1 latencies in cVEMP tests.

Electrocochleography showed higher summation potential amplitudes in VM patients.

No definitive diagnostic markers for VM were identified.

Abstract

•Vestibular Migraine (VM) is a neurological disorder which associates vertigo and headache.•Ménière's Disease (MD) is the main differential diagnosis of VM.•cVEMP, caloric test and ECoG suggests VM acts on several pathways in the vestibular system.•VM may present ECoG compatible with endolymphatic hydrops suggesting MD association.•Specific markers for the diagnosis of VM were not identified in this study.

Vestibular Migraine (VM) is a neurological disorder which associates vertigo and headache.

Ménière's Disease (MD) is the main differential diagnosis of VM.

cVEMP, caloric test and ECoG suggests VM acts on several pathways in the vestibular system.

VM may present ECoG compatible with endolymphatic hydrops suggesting MD association.

Specific markers for the diagnosis of VM were not identified in this study.

Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibular-evoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine.

Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography.

The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance.

Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops.

Level 4.

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