title: Vestibular evoked myogenic potentials in patients with vestibular migraine.
abstract: OBJECTIVE
  Literature investigating otolith reflexes in patients with vestibular migraine (VM) is variable and primarily describes the descending saccular pathway. This research aimed to study ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) prevalence and response characteristics in patients with suspected VM and in control patients. The purpose is to assess vulnerabilities within the ascending utricular and descending saccular pathways in the VM population.
  
  
  METHODS
  Retrospective study
  
  
  METHODS
  Tertiary academic referral center
  
  
  METHODS
  39 adults with VM, 29 control patients
  
  
  METHODS
  Air conducted oVEMPs and cVEMPs measured with 500 Hz tone burst stimuli
  
  
  RESULTS
  Age of headache onset was most often in childhood or adolescence, with dizziness onset occurring later. The rate of bilaterally absent oVEMPs was significantly higher (28%, p < 0.01) in the VM group compared with the control group (0%). oVEMP amplitude asymmetry ratios were significantly higher for the definite VM (p < 0.01) and probable VM (p = 0.023) groups than the control group. Eleven patients also had history of concussion; they were significantly more likely to demonstrate bilaterally absent oVEMPs (p < 0.01) in comparison to the control patients. When VM patients with a history of concussion were omitted from analysis, differences in oVEMP amplitude asymmetry (p < 0.01) and bilateral oVEMP absence remained significant (p = 0.015). There were no differences in the rate of bilateral cVEMP presence or response parameters between VM and control groups.
  
  
  CONCLUSIONS
  VEMP presentation differs for some patients diagnosed with VM. The higher rates of abnormal oVEMPs may suggest greater vulnerability within the ascending utricular-ocular pathway in patients with VM.
authors.affiliation: *Mayo Clinic Arizona, Audiology Section, Scottsdale, Arizona; †Mayo Clinic Arizona, Neurology Section, Scottsdale, Arizona; and ‡Mayo Clinic Florida, Audiology Section, Jacksonville, Florida, U.S.A.
authors.forename: Ashley
authors.initials: A
authors.lastname: Zaleski
authors.forename: Jamie
authors.initials: J
authors.lastname: Bogle
authors.forename: Amaal
authors.initials: A
authors.lastname: Starling
authors.forename: David A
authors.initials: DA
authors.lastname: Zapala
authors.forename: Laurie
authors.initials: L
authors.lastname: Davis
authors.forename: Matthew
authors.initials: M
authors.lastname: Wester
authors.forename: Michael
authors.initials: M
authors.lastname: Cevette
mesh_terms: D000293:Adolescent; D000328:Adult; D004244:Dizziness / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology*; D012018:Reflex / Q000502:physiology; D012189:Retrospective Studies; D014717:Vertigo / Q000503:physiopathology; D015837:Vestibular Diseases / Q000503:physiopathology*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D014722:Vestibule, Labyrinth / Q000503:physiopathology*; D055815:Young Adult