title: Auditory evoked potentials and vestibular evoked myogenic potentials in evaluation of brainstem lesions in multiple sclerosis.
abstract: OBJECTIVE
  The aim of this study was to determine the roles of magnetic resonance imaging (MRI), auditory evoked potentials (AEP) and vestibular evoked myogenic potentials (VEMP) in the evaluation of brainstem involvement in multiple sclerosis (MS).
  
  
  METHODS
  Altogether 32 patients with the diagnosis of MS participated in the study. The following data was collected from all patients: age, gender, Expanded Disability Status Scale (EDSS) score, brainstem functional system score (BSFS) (part of the EDSS evaluating brainstem symptomatology), and involvement of the brainstem on the brain MRI. AEP and ocular VEMP (oVEMP) and cervical VEMP (cVEMP) were studied in all patients.
  
  
  RESULTS
  BSFS, MRI, AEP, oVEMP and cVEMP involvement of the brainstem was evident in 9 (28.1%), 14 (43.8%), 7 (21.9%), 12 (37.5%) and 10 (31.0%) patients, respectively. None of the tests used showed statistically significant advantage in the detection of brainstem lesions. When combining oVEMP and cVEMP 18 (56.3%) patients showed brainstem involvement. This combination showed brainstem involvement in greater percentage than BSFS or AEP, with statistical significance (p=0.035 and p=0.007, respectively).
  
  
  CONCLUSIONS
  VEMP is a reliable method in detection of brainstem involvement in MS. It is comparable with MRI, but superior to clinical examination or AEP.
authors.affiliation: University Hospital Center Zagreb, Department of Neurology, Referral Center for Demyelinating Diseases of the Central Nervous System, Zagreb, Croatia.
authors.forename: Anita
authors.initials: A
authors.lastname: Ivanković
authors.forename: Vesna
authors.initials: V
authors.lastname: Nesek Mađarić
authors.forename: Katarina
authors.initials: K
authors.lastname: Starčević
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krbot Skorić
authors.forename: Tereza
authors.initials: T
authors.lastname: Gabelić
authors.forename: Ivan
authors.initials: I
authors.lastname: Adamec
authors.forename: Mario
authors.initials: M
authors.lastname: Habek
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D001933:Brain Stem / Q000473:pathology* / Q000503:physiopathology*; D004185:Disability Evaluation; D005072:Evoked Potentials, Auditory / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D012720:Severity of Illness Index; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D055815:Young Adult