Vestibular findings in multiple sclerosis patients

Background: Dizziness, vertigo, and imbalance combined with other clinical signs of multiple sclerosis (MS) patients like weakness, sensory loss, ataxia, may result in falls and accidents, as well as restrictions on outdoor activity, which can have a detrimental impact on social engagement and quality of life. Our aim was to identify vestibular deficits in patients with multiple sclerosis (MS). Material and methods: This retrospective cohort study was conducted on a group of 94 MS patients, aged 18 to 68 years, admitted to our clinic over the course of a year (01.02.2019 – 01.02.2020). Results: Out of 140 MS patients 94 had vestibular symptoms (59 women and 35 men, mean age 39 ± 6.3 years old). Fifty-seven patients had relapsing-remitting (RR), 27 – secondary progressive (SP), 7 – primary progressive (PP) and 1 – recurrent progressive (RP) MS form. The mean EDSS score was 4.3 ± 1.9. Imbalance was the most common reported symptom (90%), followed by dizziness (43%) and vertigo (17%). Nystagmus was present in 43% of patients, in 68% it was only horizontal and in 13% of cases unidirectional. Vertigo was more frequent in RR patients (24%), dizziness in PP form (57%) and imbalance in SP patients (96%). No significant correlations were found between disease severity (EDSS score) and vestibular findings except imbalance (p=0.037, r=0.242). Conclusions: Vestibular symptoms are common in patients with MS. Understanding the underlying mechanism of vestibulopathy (peripheral, central, BPPV) may impact on prognosis and management strategies in patients with multiple sclerosis. Therefore, a prospective study is needed