The Role of Brainstem Auditory Evoked Potentials, Electronystagmography and Transcranial Doppler in Evaluation of Patients with Vertigo

Background: vertigo may be a warning sign of impending vertebrobasilar stroke. Objective: To investigate the role of brain stem auditory evoked potential (BAEP), electronystagmography (ENG) studies and results of transcranial Doppler (TCD) in patients with vertigo of vertebrobasilar origin and patients with vertigo of non-vertebrobasilar origin. Methods: Twenty five patients with vertigo aged 40-65 and 10 controls with no history of vertigo were studied. The patients were subjected to clinical neuropsychiatric evaluation, basic audiological evaluation, BAEP, ENG and TCD. Patients were divided into 2 groups depending on history, neurological examination and laboratory investigations. Group I includes 11 patients with vertebrobasilar insufficiency (VBI), group II includes 14 patients with no manifestation of vertebrobasilar insufficiency (non-VBI). Results: In VBI group ENG was abnormal in 81.8%. TCD 72.7%, BAEP 63.6% the three tests were abnormal in 63%. In non VBI group, ENG was abnormal i n 64.2%, TCD 21.4% BAEP 14.2%. Positive correlation was found between delayed latencies of wave III & V of ABR response and pulsatility index of vertebrobasilar arteries. Conclusion: TCD combined with BAEP and ENG can lead to early recognitions of patients at risk of vertebrobasilar stroke. Hence appropriate investigations and treatment could be done to prevent this outcome. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): 511-518]