Search

Background: In multiple sclerosis (MS), even in the presence of clinical brainstem symptoms, the brainstem does not always show gross lesions on magnetic resonance imaging (MRI). However, MS may impair vestibular-evoked myogenic potential (VEMP) responses. Material and methods: This study included 70 participants, 40 who were MS patients and 30 healthy adult volunteers as controls. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cervical VEMP (cVEMP), and ocular VEMP (oVEMP). Results: Of the 40 MS patients, 37.5% had abnormal cVEMP and 67.5% had abnormal oVEMP. Some 23% of the 21 MS patients without brainstem lesions on MRI had abnormal cVEMP and oVEMP, including 69% of those who had vertigo. MS patients with brainstem lesions on MRI had significantly greater oVEMP latency than patients without similar MRI findings. Conclusions: MS patients showed dysfunction in the vestibulo-ocular and vestibulo-spinal reflexes. This dysfunction is reflected in impaired oVEMP and cVEMP respectively despite the absence of structural brainstem abnormalities. Thus, VEMP, especially oVEMP, can be used as an early indicator of brainstem involvement in MS before radiological signs appear on MRI. [ABSTRACT FROM AUTHOR]

Introduction: In migraine, there is no anatomical correlate of vertigo and no structural abnormality is evident in conventional imaging. Cervical vestibular-evoked myogenic potential (cVEMP) is an uncrossed inhibitory vestibulo-spinal reflex (VSR), while ocular VEMP (oVEMP) represents a crossed excitatory vestibulo-ocular reflex (VOR). Objective: This study aims at functional evaluation of the findings of cVEMP and oVEMP in migraine patients. Material and methods: This was a cross-sectional case-control study that included 20 migraine patients as the case group and 30 healthy adult subjects as a control group. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cVEMP, oVEMP, and posturography tests. Results: 35% of migraine patients showed delayed cVEMP latency and 40% showed abnormal oVEMP in the form of statistically significant delayed right oVEMP P1 (p = 0.050) and left oVEMP N1 latency (p = 0.038) compared with controls. cVEMP parameters were not correlated to posturography results. The majority of migraine patients (70%) had normal equilibrium pattern and normal sensory analyses ratios (65%). Only 30% had vestibular dysfunction. Conclusions: VSR and VOR are affected in migraine patients. We recommend the use of cVEMP and oVEMP in migraine patients for functional assessment of brainstem pathways. [ABSTRACT FROM AUTHOR]

Context: Pain and fatigue are common symptoms that correlated with multiple sclerosis patents, which disrupts physical, cognitive, emotional, and social functioning. Aim: evaluate the effect of acupressure on pain and fatigue among patients with multiple sclerosis. Design: Non-equivalent interrupted quasiexperimental. Sample: 60 adult male and female patients were randomly selected and divided equally into study and controls groups study was conducted at Multiple Sclerosis Research Unit affiliated with one of the biggest teaching hospital in Cairo, Egypt. Tools: Semi-Structured Interview Questionnaire, Pain Quality Assessment Scale, and Fatigue Severity Scale. Results: There was statistical significant decrease of pain and fatigue mean scores among the study group who received acupressure when compared to control group who received routine hospital care. Conclusion: Applying acupressure could be effective in reducing severity of pain and fatigue among patients with multiple sclerosis. Therefore it is recommended to endorse acupressure as a nursing practice for patients with multiple sclerosis in the early course of the disease. [ABSTRACT FROM AUTHOR]