Background: In multiple sclerosis (MS) patients, because there is a weak correlation between radiological extend determined by magnetic resonance imaging (MRI) and its clinical presentation, it is essential to find potential methods for testing brainstem affection in these patients. Consequently, we aimed to investigate the clinical value of the video head impulse test (vHIT) and vestibular evoked myogenic potential (VEMP) tests in the diagnosis of brainstem affection in MS patients, as well as to correlate them with clinical symptoms and MRI findings.
Methods: This study included fifty subjects in 2 groups; the control group included 25 normal subjects, and the study group consisted of 25 MS patients. The study group was divided into 2 subgroups according to MRI findings: MS patients without brainstem lesions (n=14) and MS patients with brainstem lesions (n=11). Basic audiological evaluation, vHIT and VEMPs were conducted to all subjects in the study.
Results: There was a statistically significant difference between control and MS patients with lesions in the brainstem in the vHIT gain of lateral and posterior canals. Both study subgroups had significantly delayed cVEMP and oVEMP latencies in comparison to the control group. Regarding cases with brainstem symptoms, they had significantly lower lateral and posterior canal gains. Moreover, they had significantly delayed cVEMP and oVEMP latencies.
Conclusion: vHIT and VEMPs are valuable tools in evaluating the involvement of the brainstem in patients with MS. Moreover, these tests can be useful in recognizing undetected brainstem lesions and thus have a predictive value for the disease progress.