Study the normative datas of vestibular evoked myogenic potential and compare with migraine patients

Anbuselvi Mattuvar Kuzhali, S (2013) Study the normative datas of vestibular evoked myogenic potential and compare with migraine patients. Masters thesis, Madras Medical College, Chennai.


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SUMMARY: VEMP arelatively new diagnostic tool was studied on 50 migraine patients and compared with age and sex matched controls. There was no significant variations of p13 and n23 latencies in either the controls or the migraine patients. The latencies did not change with regard to the age, different modes of neck torsion or the placement of inverting electrodes at different sites. P13-n23 ampltude was significantly higher when the neck was lifted forwards and turned away from the source of stimulus. Similarly the amplitude was greater when the reference electrode was placed at the sternum compared to wrist and mastoid. The amplitude decreases significantly after 50 years of age. In migraine patients with or without vertigo the amplitude showed a significant decrease. The magnitude of decrease in migraine patients was much higher. CONCLUSION: VEMP a relatively new diagnostic test to assess the vestibular pathway was studied in relation to age , neck torsion and placement of inverting electrode. A sincere attempt was also made to study the changes in VEMP in migraine patients with age-sex matched controls. VEMP response did not show much significant change in p13 and n23 latencies over different age groups but p13-n23 amplitude showed a significant decrease in the elderly which could be due to physiological degenerative changes of saccule and other vestibular apparatus including the vestibulespinal tract due to advancing age. Different modes of neck torsion did not produce any significant change in p13 or n23 latencies but there was a significant increase in p13-n23 amplitude when the head was lifted upwards and neck turned away from the source of stimulus indicating that the magnitude of VEMP amplitude correlates with the degree of neck torsion. The more nearer the inverting electrode is to the active electrode greater is the VEMP response as evidenced by the robust amplitude seen when it was placed over the sternum. The amplitude of VEMP in migraine patients, more so in migraine patients with vertigo was significantly lower compared to the controls probably due to the habituation deficit in cortical evoked potential which might be associated with hypofunction of subcortical serotoninergic input to vestibular nucleus. Although an honest attempt has been made, the study has its limitation since not much work has been done in the Indian sub-continent to compare the datas. Apart from inadequate number of subjects in the older age group a high level of motivation is necessary to elicit a good and robust response. A better understanding of the pathophysiology of migraine would throw more light on the usefulness of VEMP to demarcate migraine and vertigo associated with migraine. Further studies is being done on the usefulness of VEMP on this line.

Item Type: Thesis (Masters)
Uncontrolled Keywords: normative datas ; vestibular evoked myogenic potential ; migraine patients.
Subjects: MEDICAL > Physiology
Depositing User: Punitha K
Date Deposited: 16 Jun 2018 01:46
Last Modified: 16 Jun 2018 01:46

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