title: Subclinical vestibular dysfunction in migraine patients: a preliminary study of ocular and rectified cervical vestibular evoked myogenic potentials.
abstract: BACKGROUND
  Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Although the vestibular tests may be abnormal, the changes may exist without vestibular symptoms. To date, vestibular-evoked myogenic potential (VEMP) has been the easiest and simplest test for measuring vestibular function in clinical practice. Cervical VEMP (cVEMP) represents a vestibulo-collic reflex, whereas ocular VEMP (oVEMP) reflects a vestibulo-ocular pathway. Therefore, we determined whether ocular and rectified cervical VEMPs differed in patients with migraine or tension type headache (TTH) and compared the results to controls with no accompanying vestibular symptoms.
  
  
  METHODS
  The present study included 38 females with migraine without aura, 30 with episodic TTH, and 50 healthy controls without vestibular symptoms. oVEMP and cVEMP using a blood pressure manometer were recorded during a headache-free period. From the VEMP graphs, latency and amplitude parameters were analyzed, especially following EMG rectification in cVEMP.
  
  
  RESULTS
  With respect to oVEMP, the migraine group exhibited significantly longer mean latencies of bilateral n1 and left p1 than the other groups (p < 0.05). Amplitudes of n1-p1 were lower than in other groups, but the difference did not reach statistical significance. In regards to cVEMP, p13 and n23 latencies and amplitudes after rectification did not differ significantly among groups.
  
  
  CONCLUSIONS
  An abnormal interictal oVEMP profile was associated with subclinical vestibular dysfunction in migraineurs, suggesting pathology within the vestibulo-ocular reflex. oVEMP is a more reliable measure than cVEMP to evaluate vestibular function in migraineurs, although results from the two tests in patients with migraine are complementary.
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153 Gyo-dong, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea. gumdol52@hallym.or.kr.
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153 Gyo-dong, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea. mujang@hallym.or.kr.
authors.forename: Min-Uk
authors.initials: MU
authors.lastname: Jang
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153 Gyo-dong, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea. dohchi@hallym.or.kr.
authors.forename: Hui-Chul
authors.initials: HC
authors.lastname: Choi
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153 Gyo-dong, Chuncheon-si, Gangwon-do, 200-704, Republic of Korea. deepfoci@hallym.or.kr.
authors.forename: Jong-Hee
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology*; D011930:Reaction Time; D018781:Tension-Type Headache / Q000503:physiopathology*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D055815:Young Adult
keywords: Cervical VEMP; Migraine; Ocular VEMP; Vestibular evoked myogenic potential (VEMP)