Vestibular Evoked Myogenic Potentials in Cervical Myofascial Pain Syndrome

Indian J Otolaryngol Head Neck Surg, 2022 · DOI: https://doi.org/10.1007/s12070-021-02772-w · Published: August 3, 2021

Simple Explanation

This study explores the use of Vestibular Evoked Myogenic Potentials (VEMPs) to assess the vestibular system function, specifically the saccule, in patients with Cervical Myofascial Pain Syndrome with dizziness (CMPS-D). Two types of VEMPs were used: SCMVEMPs and SETMPs. SCMVEMPs are a conventional method recorded from neck muscles, while SETMPs are recorded from triceps muscles and have different nerve connections. The study compares these VEMP responses in CMPS-D patients versus a control group. The purpose was to determine if these tests can aid in diagnosing CMPS-D, assessing saccular function, and understanding the cause of dizziness in these patients. To our knowledge, no previous studies have investigated the SETMP and SCM-VEMP in subjects with CMPS-D.

Study Duration

Not specified

Participants

30 (15 CMPS-D patients, 15 healthy controls)

Evidence Level

Cross-sectional comparative study

Key Findings

1
The SCMVEMP response was absent in 4 of 15 patients with CMPS-D, and the mean response in the CMPS-D group was significantly lower than the control group.
2
There was no significant difference in amplitude and latency of SETMP between the CMPS-D group and the control group.
3
A significant correlation was found between the amplitudes of SCM-VEMP and SETMP.

Research Summary

The study investigated SCM-VEMP and SETMP responses in patients with CMPS-D compared to a control group to assess saccular function and the etiology of dizziness. SCM-VEMP amplitudes were significantly reduced or absent in CMPS-D subjects, while SETMP responses remained normal. The researchers suggest that diminished SCM-VEMP responses in CMPS-D may not indicate saccular injury but could relate to reduced neck muscle contraction due to pain avoidance.

Practical Implications

Diagnostic Alternative

SETMP tests are suitable alternatives for saccule evaluation in CMPS-D subjects with false absent SCMVEMP response.

Understanding Dizziness

The involvement of spinal cord pathways is not a primary cause of dizziness in CMPS-D patients.

Clinical Assessment

Clinicians should consider pain-related muscle tension when interpreting SCM-VEMP results in CMPS-D patients.

Study Limitations

1
The sample size of 15 patients in each group is relatively small.
2
The study did not directly measure neck muscle tonic contraction.
3
The study acknowledges that they cannot explain why other subjects with VAS pain above 5 showed a normal SCM-VEMP response.

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