scholarly journals Cervical Vestibular-Evoked Myogenic Potentials: Norms and Protocols

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Suwicha Isaradisaikul ◽  
Niramon Navacharoen ◽  
Charuk Hanprasertpong ◽  
Jaran Kangsanarak
Keyword(s):  
Vestibular Function ◽  
Tone Burst ◽  
Contralateral Side ◽  
Vestibular Evoked Myogenic Potentials ◽  
Normative Values ◽  
Vestibular Evoked Myogenic Potential ◽  
Reference Guide ◽  
Inferior Vestibular Nerve ◽  
Set Up ◽  
Vestibular Function Test

Vestibular-evoked myogenic potential (VEMP) testing is a vestibular function test used for evaluating saccular and inferior vestibular nerve function. Parameters of VEMP testing include VEMP threshold, latencies of p1 and n1, and p1-n1 interamplitude. Less commonly used parameters were p1-n1 interlatency, interaural difference of p1 and n1 latency, and interaural amplitude difference (IAD) ratio. This paper recommends using air-conducted 500 Hz tone burst auditory stimulation presented monoaurally via an inserted ear phone while the subject is turning his head to the contralateral side in the sitting position and recording the responses from the ipsilateral sternocleidomastoid muscle. Normative values of VEMP responses in 50 normal audiovestibular volunteers were presented. VEMP testing protocols and normative values in other literature were reviewed and compared. The study is beneficial to clinicians as a reference guide to set up VEMP testing and interpretation of the VEMP responses.

scholarly journals Tone Burst Masseter Vestibular Evoked Myogenic Potentials: Normative Values and Test–Retest Reliability

2021 ◽  
Author(s):  
Sangu Srinivasan Vignesh ◽  
Niraj Kumar Singh ◽  
Krishna Rajalakshmi
Keyword(s):  
Research Design ◽  
Intraclass Correlation ◽  
Tone Burst ◽  
Peak Amplitude ◽  
Vestibular Evoked Myogenic Potentials ◽  
Normative Values ◽  
Asymmetry Ratio ◽  
Vestibular Evoked Myogenic Potential ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Background Masseter vestibular evoked myogenic potential (mVEMP) is a recent tool for the assessment of vestibular and trigeminal pathways. Though a few studies have recorded mVEMP using click stimuli, there are no reports of these potentials using the more conventional VEMP eliciting stimuli, the tone bursts. Purpose The aim of the study is to establish normative values and determine the test–retest reliability of tone burst evoked mVEMP. Research Design The research design type is normative study design. Study Sample Forty-four healthy participants without hearing and vestibular deficits in the age range of 18 to 50 years participated in the study. Data Collection and Analysis All participants underwent mVEMP testing using 500 Hz tone-burst stimuli at 125 dB peSPL. Ten participants underwent second mVEMP testing within 1 month of the initial testing to estimate the test–retest reliability. Results Tone burst mVEMP showed robust responses in all participants. There were no significant ear and sex differences on any mVEMP parameter (p > 0.05); however, males had significantly higher EMG normalized peak-to-peak amplitude than females. Intraclass correlation coefficient (ICC) values of tone burst mVEMP showed excellent test–retest reliability (ICC >0.75) for ipsilateral and contralateral p11 latency, ipsilateral EMG normalized p11-n21 peak to peak amplitude, and amplitude asymmetry ratio. Fair and good test–retest reliability (0.4 < ICC > 0.75) was observed for ipsilateral and contralateral n21 latency, contralateral EMG normalized peak-to-peak amplitude, and amplitude asymmetry ratio. Conclusion Tone burst mVEMP is a robust and reliable test for evaluating the functional integrity of the vestibulomasseteric reflex pathway.

scholarly journals Toward Optimizing cVEMP: 2,000-Hz Tone Bursts Improve the Detection of Superior Canal Dehiscence

2018 ◽  
Vol 23 (6) ◽  
pp. 335-344 ◽  
Author(s):  
Kimberley S. Noij ◽  
Barbara S. Herrmann ◽  
John J. Guinan Jr. ◽  
Steven D. Rauch
Keyword(s):  
Roc Analysis ◽  
Matched Control ◽  
Tone Burst ◽  
Sound Level ◽  
Vestibular Evoked Myogenic Potential ◽  
Superior Semicircular Canal Dehiscence ◽  
Myogenic Potential ◽  
Superior Canal Dehiscence ◽  
Inferior Vestibular Nerve ◽  
Canal Dehiscence

Background: The cervical vestibular evoked myogenic potential (cVEMP) test measures saccular and inferior vestibular nerve function. The cVEMP can be elicited with different frequency stimuli and interpreted using a variety of metrics. Patients with superior semicircular canal dehiscence (SCD) syndrome generally have lower cVEMP thresholds and larger amplitudes, although there is overlap with healthy subjects. The aim of this study was to evaluate which metric and frequency best differentiate healthy ears from SCD ears using cVEMP. Methods: Twenty-one patients with SCD and 23 age-matched controls were prospectively included and underwent cVEMP testing at 500, 750, 1,000 and 2,000 Hz. Sound level functions were obtained at all frequencies to acquire threshold and to calculate normalized peak-to-peak amplitude (VEMPn) and VEMP inhibition depth (VEMPid). Third window indicator (TWI) metrics were calculated by subtracting the 250-Hz air-bone gap from the ipsilateral cVEMP threshold at each frequency. Ears of SCD patients were divided into three groups based on CT imaging: dehiscent, thin or unaffected. The ears of healthy age-matched control subjects constituted a fourth group. Results: Comparing metrics at all frequencies revealed that 2,000-Hz stimuli were most effective in differentiating SCD from normal ears. ROC analysis indicated that for both 2,000-Hz cVEMP threshold and for 2,000-Hz TWI, 100% specificity could be achieved with a sensitivity of 92.0%. With 2,000-Hz VEMPn and VEMPid at the highest sound level, 100% specificity could be achieved with a sensitivity of 96.0%. Conclusion: The best diagnostic accuracy of cVEMP in SCD patients can be achieved with 2,000-Hz tone burst stimuli, regardless of which metric is used.

Comparison of vestibular evoked myogenic potentials elicited by click and short duration tone burst stimuli

2010 ◽  
Vol 125 (4) ◽  
pp. 343-347 ◽  
Author(s):  
K Kumar ◽  
S Kumar Sinha ◽  
A Kumar Bharti ◽  
A Barman
Keyword(s):  
Short Duration ◽  
Clinical Assessment ◽  
Low Frequency ◽  
Tone Burst ◽  
Normal Hearing ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Acoustic Stimuli ◽  
Myogenic Potential ◽  
Electrical Impulses

AbstractIntroduction:Vestibular evoked myogenic potentials are short latency electrical impulses that are produced in response to higher level acoustic stimuli. They are used clinically to diagnose sacculocollic pathway dysfunction.Aim:This study aimed to compare the vestibular evoked myogenic potential responses elicited by click stimuli and short duration tone burst stimuli, in normal hearing individuals.Method:Seventeen subjects participated. In all subjects, we assessed vestibular evoked myogenic potentials elicited by click and short duration tone burst stimuli.Results and conclusion:The latency of the vestibular evoked myogenic potential responses (i.e. the p13 and n23 peaks) was longer for tone burst stimuli compared with click stimuli. The amplitude of the p13–n23 waveform was greater for tone burst stimuli than click stimuli. Thus, the click stimulus may be preferable for clinical assessment and identification of abnormalities as this stimulus has less variability, while a low frequency tone burst stimulus may be preferable when assessing the presence or absence of vestibular evoked myogenic potential responses.

Vestibular evoked myogenic potentials: review

2010 ◽  
Vol 124 (10) ◽  
pp. 1043-1050 ◽  
Author(s):  
R Mudduwa ◽  
N Kara ◽  
D Whelan ◽  
Anirvan Banerjee
Keyword(s):  
Vestibular Function ◽  
Extensive Study ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Clinical Role ◽  
Myogenic Potential ◽  
Future Developments ◽  
Early Results ◽  
Clinical Conditions ◽  
Based Medicine

AbstractBackground:Disorders of balance often pose a diagnostic conundrum for clinicians, and a multitude of investigations have emerged over the years. Vestibular evoked myogenic potential testing is a diagnostic tool which can be used to assess vestibular function. Over recent years, extensive study has begun to establish a broader clinical role for vestibular evoked myogenic potential testing.Objectives:To provide an overview of vestibular evoked myogenic potential testing, and to present the evidence for its clinical application.Review type:Structured literature search according to evidence-based medicine guidelines, performed between November 2008 and April 2009. No restrictions were applied to the dates searched.Conclusion:The benefits of vestibular evoked myogenic potential testing have already been established as regards the diagnosis and monitoring of several clinical conditions. Researchers continue to delve deeper into potential new clinical applications, with early results suggesting promising future developments.

scholarly journals Vestibular evoked myogenic potential

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 38-45
Author(s):  
Slobodanka Lemajic-Komazec ◽  
Zoran Komazec ◽  
Ljiljana Vlaski ◽  
Slobodan Savovic ◽  
Maja Buljcik-Cupic ◽  
...  
Keyword(s):  
Tone Burst ◽  
Acoustic Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Average Value ◽  
Myogenic Potential ◽  
The Difference ◽  
Interaural Differences ◽  
The Right ◽  
A Prospective Study

Introduction. Vestibular evoked myogenic potentials are neurophysiological method for examining of saccular function, the bottom of the vestibular nerve that in nervates the sacculus and central vestibular pathways. Those are inhibitory potentials of the sternocleido mastoid musclein response to ipsilateral acoustic stimulation of the sacculus. Parameters of vestibular evoked myogenic potential testing include threshold, latencies of p1 and n1 wave and interamplitude p13-n23, interaural difference of p13 and n23 latency and interaural amplitude difference ratio. The aim of this study was to compire parameters standardization of vestibular evoked myogenic potentials responses, latency p13 and n23 of waves, the amplitude of responses and interaural differences in the amplitude andto determinewhether there is a difference in values between the sexes. Material and methods. This research was meant to be a prospective study which included 30 normal audiovestibular volunteers of both sexes. The group consisted of 53.3% women and 46.7% men. The saccular function testing by vestibular evoked myogenic potentials was performed monoaurally using air-conductive 500 Hz tone burst auditory stimulation. Results. The average value of the p13 wave latency in healthy subjects of this study was 15.18 ms (?1.24) while the mean latency of n23 waves in the same subjects was 25.00 ms (?2.23). The average value of the amplitude of the p13-n23 waves was 80.28 (34. ?04) microvolts. Conclusion. The difference in the values of the basic parameters of vestibular evoked myogenic potential responses between men and women does not exist. No differences between the right and the left ear in the values of latency and amplitude were observed.

Case Study: Depersonalization and Vestibular Impairment

2021 ◽  
Author(s):  
Yini Sun ◽  
Allison Coltisor ◽  
Gary P. Jacobson ◽  
Richard A. Roberts
Keyword(s):  
Vestibular Function ◽  
Retrospective Chart Review ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Vestibular Evoked Myogenic Potential ◽  
Episodic Vertigo ◽  
Data Collection And Analysis ◽  
Vestibular Function Testing ◽  
Function Testing

Abstract Background We describe herein the case of a patient whose primary complaints were episodic vertigo and “depersonalization,” a sensation of detachment from his own body. Purpose This case study aims to further clinical knowledge and insight into the clinical evaluation of vertiginous patients with complaints of depersonalization. Research Design This is a case study. Data Collection and Analysis A retrospective chart review of vestibular function testing done on a vertiginous patient with complaints of depersonalization was performed. Results Vestibular function testing revealed absent cervical and ocular vestibular evoked myogenic potentials on the left side with normal vHIT or video Head Impulse Test, videonystagmography, and rotational chair results, suggesting peripheral vestibular impairment isolated to the left saccule and utricle. Conclusion The otolith end organ impairment explains the patient's postural deviation to the left side during attempts to ambulate. We recommend that clinicians should be attentive to patient complaints of depersonalization and perform vestibular evoked myogenic potential testing to determine whether evidence of at least a unilateral peripheral otolith end organ impairment exists.

Preservation of tap vestibular evoked myogenic potentials despite resection of the inferior vestibular nerve

2004 ◽  
Vol 14 (4) ◽  
pp. 347-351 ◽  
Author(s):  
Krister Brantberg ◽  
Tiit Mathiesen
Keyword(s):  
Bone Conduction ◽  
Vestibular Function ◽  
Vestibular Nerve ◽  
Vestibular Evoked Myogenic Potentials ◽  
Nerve Function ◽  
Sound Stimulation ◽  
Vestibular Loss ◽  
Vestibular Neurectomy ◽  
Inferior Vestibular Nerve ◽  
Healthy Side

Sound and skull-tap induced vestibular evoked myogenic potentials (VEMP) were studied in a 43-year-old man following inferior vestibular neurectomy. Surgery was performed because of a small acoustic neuroma. Postoperative caloric testing suggested sparing of superior vestibular nerve function on the operated side. In response to sound stimulation there were no VEMP on the operated side, irrespective of whether sounds were presented by air- or bone-conduction. This suggests sound-induced VEMP to be critically dependent on inferior vestibular nerve function and this is in agreement with present knowledge. However, VEMP were obtained in response to forehead skull taps, i.e. positive-negative VEMP not only on the healthy side but also on the operated side. This suggests remnant vestibular function on the operated side of importance for forehead skull tap VEMP, because with complete unilateral vestibular loss there are no (positive-negative) VEMP on the lesioned side. Thus, forehead skull-tap VEMP depend, at least partly, on the superior vestibular nerve function.

scholarly journals Assessment of Vestibular and Oculomotor Function in Patients with Vestibular Migraine: A Preliminary Study

2020 ◽  
Author(s):  
Wei Fu ◽  
Junliang Han ◽  
Feng He ◽  
Ya Bai ◽  
Dong Wei ◽  
...  
Keyword(s):  
Vestibular Function ◽  
Test Group ◽  
Vestibular Migraine ◽  
Vestibular Evoked Myogenic Potentials ◽  
Caloric Irrigation ◽  
Function Test ◽  
Abnormal Rate ◽  
Vestibular Function Test ◽  
Oculomotor Function ◽  
The Relationship

Abstract Background: The purpose of the study is to assess the vestibular and oculomotor function in patients with vestibular migraine(VM).And we also investigate the relationship between test resultsandeffectiveness of prophylactic medication.Methods: We recruited 41 patientswith VM. They were examinedwith vestibular-evoked myogenic potentials(VEMP), video head impulse test(vHIT) and videonystagmography(VNG), including spontaneous or positional nystagmus, gaze-evoked nystagmus, smooth pursuit and caloric irrigation testing.All VM patients were treated withprophylactic medications. Theintensity of vertigo were evaluated with dizziness handicap inventory(DHI) before and after treatment. After 6 months, we evaluate the effectiveness of prophylactic medication. We analyzed the relationship between test resultsandeffectiveness of prophylactic medication.Results:In vestibular function test,71% of VM patients showed abnormal result. 20% showed abnormal air-conducted cVEMP and 42% showed abnormal air-conducted oVEMP. 32% showed abnormal vHIT and 56% showed abnormal caloric irrigation test.The abnormal rate of oVEMP was significantly higher than cVEMP (p<0.05). And the abnormal rate of caloric irrigation test was significantly higher than vHIT(p<0.05). In oculomotor function test, 42% showed pathological result. The abnormal rate of oculomotor function test was significantly lower than vestibular function test (p<0.05). After 6 months follow-up, rate of good effectiveness was significantly higher in normal vestibular function test group compared with the abnormal vestibular function test group (p<0.05). Rate of good effectiveness was no statistically significant difference between normal oculomotor function test group and abnormal oculomotor function test group (p>0.05).Conclusions: Abnormal vestibular and oculomotor function are commonly observed in VM patients. And VM patients with abnormal vestibular function have a weak effectiveness of prophylaxis medications.

Vestibular evaluation in children with otitis media with effusion

2015 ◽  
Vol 129 (4) ◽  
pp. 326-336 ◽  
Author(s):  
E A Kolkaila ◽  
A A Emara ◽  
T A Gabr
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Vestibular Function ◽  
Vestibular Evoked Myogenic Potentials ◽  
Control Group ◽  
Dizziness Handicap Inventory ◽  
Vestibular Evoked Myogenic Potential ◽  
Bedside Test ◽  
Bedside Tests ◽  
Serous Otitis Media

AbstractBackground:Fifty per cent of children with serous otitis media may have some balance disturbances.Objective:To evaluate vestibular function in children with otitis media with effusion.Methods:The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air–bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing.Results:Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group.Conclusion:The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

Inferior vestibular neuritis: a novel subtype of vestibular neuritis

2009 ◽  
Vol 124 (5) ◽  
pp. 477-481 ◽  
Author(s):  
D Zhang ◽  
Z Fan ◽  
Y Han ◽  
G Yu ◽  
H Wang
Keyword(s):  
Pure Tone Audiometry ◽  
Systematic Investigation ◽  
Vestibular Neuritis ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Caloric Testing ◽  
Myogenic Potential ◽  
Lower Amplitude ◽  
Cerebral Computed Tomography ◽  
Inferior Vestibular Nerve

AbstractObjective:To report eight cases of inferior vestibular neuritis, in order to raise awareness of this new subtype of vestibular neuritis.Materials and methods:We retrospectively analysed 216 patients (104 males and 112 females; age range 10–64 years; mean age 38.4 years) with full clinical documentation who had attended our hospital's vertigo clinic between May 2007 and December 2008. All patients underwent systematic investigation, including hearing tests, radiology, caloric testing and vestibular evoked myogenic potential testing.Results:Of 216 patients with vestibular neuritis, eight cases were diagnosed as inferior vestibular neuritis, based on comprehensive analysis of test data. The clinical features of these eight patients were consistent with the characteristics of vestibular neuritis. The results of pure tone audiometry and caloric testing were normal, and the possibility of central lesions was excluded by cerebral computed tomography or magnetic resonance imaging on admission. Six cases had unilateral loss of vestibular evoked myogenic potentials, whereas two had a unilateral lower amplitude of vestibular evoked myogenic potentials.Conclusions:Inferior vestibular neuritis is a novel subtype of vestibular neuritis, which involves the inferior vestibular nerve alone. Vestibular evoked myogenic potential testing is a useful aid to the diagnosis of inferior vestibular neuritis.

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