Clinical and electronystagmographical evaluation of vestibular symptoms in relapsing remitting multiple sclerosis

Abstract

Objective: Multiple sclerosis (MS) may give rise to a variety of clinical signs and symptoms including vertigo and/or other problems related with equilibrium. In this study, we aimed to evaluate clinical and electronystagmographical (ENG) characteristics of relapsing remitting MS (RRMS) patients.

Design: This is a prospective controlled study consisting of 30 patients who were diagnosed as definite RRMS according to McDonald's diagnostic criteria and 30 healthy individuals.

Setting: Entire population of patients were examined and followed up at the same tertiary centre during the period of September 2003 and March 2005. Clinical examination and detailed electronystagmographic investigations were performed in each group.

Methods: Vestibular laboratory testing was carried out by a computerized ENG system. All ENG subtests including tracking, saccade, optokinetic, gaze, positional and Dix-Hallpike tests were performed in each group but caloric, which is relatively an invasive test, was performed only in the patient group.

Main outcome measures: We aimed to find the ratio of abnormal tests indicating, central and/or peripheral pathology in ENG. We also analyzed the correlation of total number of abnormal tests in ENG with clinical parameters.

Results: Differences of ENG abnormality indicating central and/or peripheral pathology and ENG abnormality indicating only central pathology between the two groups were statistically significant. Correlation of total number of abnormal tests in ENG with EDSS score was statistically significant.

Conclusion: ENG is sensitive in detecting the vestibular system involvement in RRMS patients if all subtests are performed and evaluated in detail with clinical symptoms and signs.

Keywords:

• MULTIPLE SCLEROSIS
• VESTIBULAR SYSTEM
• ELECTRONYSTAGMOGRAPHY
• VERTIGO
• NON-VERTIGINOUS DIZZINESS