Cervical vestibular evoked myogenic potentials to air-conducted sound in early amyotrophic lateral sclerosis

Summary Objectives Cervical vestibular evoked myogenic potentials (cVEMPs) provide assessment of lower-brainstem lesions affecting their neuronal pathways. We aimed to determine whether cVEMPs to air-conducted sound (ACS) are also abnormal in patients with early stages of amyotrophic lateral sclerosis (ALS), with or without bulbar involvement. Methods cVEMPs were recorded in 22 ALS patients and 23 age- and sex-matched healthy volunteers. Their latencies and amplitudes were compared between the ALS patients and the control group. Results cVEMPs were obtained in all ALS patients and controls. P13 and N23 latencies and P13 –N23 amplitudes did not significantly differ between controls and ALS patients, either with or without bulbar involvement. Conclusions We postulate that the ACS–cVEMP neural pathway is not affected in patients with early stages of ALS, even with clinical findings of bulbar involvement. Therefore, ACS–cVEMP is not a sensitive diagnostic tool for early detection of brainstem involvement in patients with ALS.