The Role of Vestibular Evoked Myogenic Potentials in Multiple Sclerosis: A Systematic Review

Background: A chronic autoimmune condition that affects the central nervous system is called multiple sclerosis (MS). The immune system starts a protective attack against its own tissues (the myelin sheath). MS may affect peripheral vestibular apparatus of the ear, or central vestibular pathways, or both. Aim: The aim of the study is to summarize the evidence on the role of vestibular evoked Myogenic potential (VEMP) as a tool to detect lesions in the vestibular pathways in the patients of MS. Methods: During the development of this meta-analysis, we adhered to the PRISMA statement's principles and followed the Cochrane handbook of systematic reviews of interventions for each step. We searched PubMed, Google Scholar, and Egyptian Knowledge Bank (Scopus) till February 2022 with relevant keywords. Results: Final qualitative synthesis contained 24 studies in all, and 1257 patients were involved in the quantitative analysis (352 Male, 655 Female). A statistically difference in the latency of P13 in cVEMP, N1 in oVEMP, P1 in oVEMP between MS patients and controls with a P value < 0.0001 .The latency of N23 in cVEMP has no significant difference between multiple sclerosis patients and healthy controls. MS patients with normal VEMP response have significantly lower vestibular symptoms than those with abnormal VEMP results. Conclusion: VEMPs can be used as an adjuvant tool in assessment of MS patients as it can detect lesions in the vestibular system, but it cannot determine the exact location of the lesion.