Vestibular dysfunction in systemic sclerosis

ABSTRACT

Systemic sclerosis is a chronic connective tissue disease characterized by multisystem affection. Nervous system involvement in the form of peripheral and cranial nerve affection has been reported in systemic sclerosis [SSc] patients. To study the possible occurrence of vestibular dysfunction in SSc and to determine its nature [peripheral or central]. Also, we aimed to correlate any vestibular involvement with clinical and laboratory data of the patients. Fifteen female patients suffering from SSc were included in this study. All patients were subjected to careful history taking, clinical examination, basic audiological examination, vestibular test battery in the form of Vestibular Evoked Myogenic Potentials [VEMP] and Videonystagmography [VNG]. VNG included bithermal caloric test to assess the semicircular canal and superior vestibular nerve while the oculomotor test battery was used to assess the central pathway. Out of the 15 female patients included in this study, nine patients was suffering from limited SSc [60%] while six patients had diffuse SSc [40%]. The mean age was 37.56 +/- 11.89 years with mean disease duration 8.43 +/- 7.3 years. The results of our study showed a high incidence of vestibular dysfunction in SSc patients where 13 patients [86.66%] showed abnormality in one or more of vestibular tests, 12 patients [80%] having abnormal VEMP results and 3 patients [19.99%] having abnormal caloric test. Our study showed that Systemic sclerosis has definite vestibular involvement. The results of VEMP and VNG showed definite peripheral vestibular pattern of dysfunction. Our results revealed peripheral vestibular dysfunction which is suspected to be due to vascular or inflammatory vestibular neuropathy