Clinical use of vestibular evoked myogenic potential in migraine

Abstract

Objective To assess migraineurs' vestibular function and reflex pathway of occular⁃brainstem⁃cervical muscle by recording and analysing vestibular evoked myogenic potential (VEMP), and discuss the VEMP clinical value. Methods VEMP and different kinds of manifestation were investigated in 39 migraineurs. According to clinical characteristics, migraineurs were divided into several subgroups with or without aura, male or female, and with or without positive family history. The results of VEMP were compared between subgroups. Results There were 13 of 39 migraineurs' VEMP abnormal and the abnormal rate was 33.33%: 4 migraineurs without response bilaterally, one migraineur without response on one side and with decreased amplitude on the other side, 2 migraineurs with decreased amplitude bilaterally, and 6 migraineurs with increased ratio of bilateral amplitude or asymmetry. The latency of P13 and N23 of the patients were all in normal range. The difference of abnormal VEMP rate in migraineurs with aura (28.57%, 4/14) and that in migraineurs without aura (36%, 9/25) was not significant (χ2 = 0.014, P = 0.906). No significant difference was seen between the rate of abnormal VEMP in male (30%, 3/10) and that in female (34.48%, 10/29; χ2 = 0.017, P = 0.897). There was significant difference between the abnormal VEMP rate in patients with positive family history (66.67%, 8/12) and that without family history (18.52%, 5/27; χ2 = 6.635, P = 0.001). Conclusion Migraineurs' vestibular function may exist abnormal subclinical features which mainly indicate the asymmetry in bilateral reflex pathway of occular⁃brainstem⁃ cervical muscle. Migraineurs with positive family history are prone to present this abnormality. VEMP may be a clue in the selection of prophylactic agents for migraineurs.

DOI：10.3969/j.issn.1672-6731.2010.06.009