Ocular vestibular evoked myogenic potential elicited from binaural air-conducted stimulations: clinical feasibility in patients with peripheral vestibular dysfunction

OBJECTIVE: Our goal was to clarify the clinical significance of vibration-induced nystagmus (VIN). METHODS: One hundred patients with unilateral vestibulocochlear disorders were enrolled into this study. However, patients with spontaneous nystagmus were excluded. Vibratory stimuli (approximately 100 Hz) were presented to the mastoids and the forehead. Patients also underwent caloric testing and vestibular evoked myogenic potential testing. RESULTS: Of the 100 patients, 60 (60%) showed VIN. The nystagmus was mainly horizontal. VIN was more frequently evoked on the mastoids than the forehead. In the majority of patients, the direction of VIN was toward the healthy side, whereas some patients, especially patients with Meniere's disease, showed nystagmus toward the affected side. VIN was frequently evoked in patients with severe unilateral vestibular damages (canal paresis >50%) (39 of 43, or 90%). CONCLUSION: VIN testing is a simple and sensitive clinical test that indicates unilateral vestibular dysfunction.

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Vestibular prognosis in idiopathic sudden sensorineural hearing loss with vestibular dysfunction treated with oral or intratympanic glucocorticoids: a protocol for randomized controlled trial

Trials ◽

10.1186/s13063-020-04579-6 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Weiming Hao ◽

Liping Zhao ◽

Huiqian Yu ◽

Huawei Li

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Vestibular Function ◽

Vestibular Dysfunction ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Vestibular Evoked Myogenic Potential ◽

Hearing Outcome ◽

Myogenic Potential ◽

Secondary Outcomes

Abstract Background Idiopathic sudden sensorineural hearing loss (ISSNHL) is a rapid-onset sensorineural hearing impairment with unclear etiology and unsatisfying treatment effects. Vestibular dysfunction has been considered as a poor indicator in the clinical manifestations and prognosis of ISSNHL, which occurred in approximately 28–57% cases. Glucocorticoids, administered through oral or intratympanic way, are currently regularly and standardly applied for ISSNHL to improve the hearing outcome. However, the vestibular prognosis of ISSNHL after routine treatments remains seldom explored. This study aims to compare the effectiveness of oral and intratympanic glucocorticoids in ISSNHL with vestibular dysfunction in terms of the pattern and trajectory of possible process of vestibular function recovery. Methods/design A randomized, outcome-assessor- and analyst-blinded, controlled, clinical trial (RCT) will be carried out. Seventy-two patients with ISSNHL complaining of vestibular dysfunction appearing as vertigo or imbalance will be recruited and randomized into either oral or intratympanic glucocorticoid therapy group with a 1:1 allocation ratio. The primary outcomes will be vestibular function outcomes assessed by sensory organization test, caloric test, video head impulse test, cervical vestibular evoked myogenic potential, and ocular vestibular evoked myogenic potential; the secondary outcomes include self-reported vestibular dysfunction symptoms; dizziness-related handicap, visual analogue scale for vertigo and tinnitus; and pure tone audiometry. Assessments of primary outcomes will be performed at baseline and at 4 and 8 weeks post-randomization, while assessments of secondary outcomes will be performed at baseline and 1, 2, 4, and 8 weeks post-randomization. Discussion Previous intervention studies of ISSNHL included only hearing outcomes, with little attention paid on the prognosis of vestibular dysfunction. This trial will be the first RCT study focusing on the progress and prognosis of vestibular dysfunction in ISSNHL. The efficacy of two commonly used therapies of glucocorticoids will be compared in both auditory and vestibular function fields, rather than in the hearing outcome alone. Trial registration ClinicalTrials.gov NCT03974867. Registered on 23 July 2019

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Diagnostic capabilities of the vestibular evoked myogenic potential test in children with vestibular dysfunction

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201275 ◽

2020 ◽

Vol 6 (4) ◽

pp. 606 ◽

Cited By ~ 1

Author(s):

Kalina I. Madzharova ◽

Ana P. Beshkova

Keyword(s):

Vestibular Dysfunction ◽

Otolith Organs ◽

Vestibular Evoked Myogenic Potential ◽

Additional Method ◽

Analysis And Evaluation ◽

Myogenic Potential ◽

Ocular Vemp ◽

Cervical Vemp ◽

Diagnostic Capabilities

Background: Vestibular evoked myogenic potential (VEMP) testing is used in the diagnosis of vestibular disorders. It is an objective method for testing the the otolith organs of the vestibular system. VEMP test is an additional method for diagnosing vestibular neuritis (VN). The combination of cervical VEMP (cVEMP) and ocular VEMP (oVEMP) testing has an advantage in long-term monitoring of patients with VN. The VEMP test is well-studied for adults but studies involving children are insufficient. The aim of this study was to analysis and evaluation of the results from VEMP testing of children diagnosed with vestibular dysfunction. Analysis and evaluation of the results from VEMP testing of children diagnosed with vestibular dysfunction.Methods: History, examination of ENT organs, tone threshold audiometry, tympanometry, otoneurological examination, VEMP test. Results: Children with vestibular dysfunction who were examined showed changes predominantly in the oVEMP test. The upper branch of the vestibular nerve is affected. Conclusions: The VEMP test is an additional method for diagnosing patients with vestibular dysfunction. It is safe when used for children.

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Role of cervical vestibular evoked myogenic potential response in identifying vestibular dysfunction

The Journal of Laryngology & Otology ◽

10.1017/s0022215113001655 ◽

2013 ◽

Vol 127 (9) ◽

pp. 848-853 ◽

Cited By ~ 1

Author(s):

S Isaradisaikul ◽

N Navacharoen ◽

C Hanprasertpong ◽

J Kangsanarak

Keyword(s):

Tone Burst ◽

Normal Subjects ◽

Vestibular Dysfunction ◽

University Hospital ◽

Response Threshold ◽

Potential Response ◽

Vestibular Evoked Myogenic Potential ◽

Myogenic Potential ◽

Vestibular Tests ◽

A Prospective Study

AbstractObjectives:To analyse cervical vestibular evoked myogenic potential response parameters in normal volunteers and vertiginous patients.Subjects and methods:A prospective study of 50 normal subjects and 50 patients with vertigo was conducted at Chiang Mai University Hospital, Thailand. Cervical vestibular evoked myogenic potential responses were measured using air-conducted, 500-Hz, tone-burst stimuli with subjects in a sitting position with their head turned toward the contralateral shoulder.Results:The mean ± standard deviation age and male:female ratio in the normal (44.0 ± 9.3 years; 12:38) and vertigo groups (44.7 ± 9.8 years; 17:33) were not significantly different. The prevalence of absent responses in the normal (14 per cent) and vertigo ears (46 per cent) differed significantly (p < 0.0001). Other cervical vestibular evoked myogenic potential parameters (i.e. response threshold, P1 and N1 latency, P1–N1 interlatency and interamplitude, inter-ear difference in P1 threshold, and asymmetry ratio) showed no inter-group differences.Conclusion:The absence of a cervical vestibular evoked myogenic potential response is useful in the identification of vestibular dysfunction. However, patients should undergo a comprehensive battery of other vestibular tests to supplement their cervical vestibular evoked myogenic potential response findings.

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The Effect of Recording Montage and Tone Burst Duration on Cervical and Ocular Vestibular Evoked Myogenic Potential Latency and Amplitude

American Journal of Audiology ◽

10.1044/2018_aja-17-0055 ◽

2019 ◽

Vol 28 (2) ◽

pp. 300-307

Author(s):

Kaylee J. Smith ◽

Devin L. McCaslin ◽

Gary P. Jacobson ◽

Robert Burkard

Keyword(s):

Tone Burst ◽

Burst Duration ◽

Vestibular Evoked Myogenic Potential ◽

Myogenic Potential

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Quantifying the effects of electrode placement and montage on measures of cVEMP amplitude and muscle contraction

Journal of Vestibular Research ◽

10.3233/ves-200033 ◽

2020 ◽

pp. 1-13

Author(s):

Sendhil Govender ◽

Sally M. Rosengren

Keyword(s):

Muscle Contraction ◽

Normal Subjects ◽

Electrode Placement ◽

Electrode Position ◽

Test Results ◽

Vestibular Evoked Myogenic Potential ◽

Active Electrode ◽

Myogenic Potential ◽

Position Errors ◽

Test Outcomes

BACKGROUND: The cervical vestibular evoked myogenic potential (cVEMP) can be affected by the recording parameters used to quantify the response. OBJECTIVE: We investigated the effects of electrode placement and montage on the variability and symmetry of sternocleidomastoid (SCM) contraction strength and cVEMP amplitude. METHODS: We used inter-side asymmetries in electrode placement to mimic small clinical errors in twenty normal subjects. cVEMPs were recorded at three active electrode sites and referred to the distal SCM tendon (referential montages: upper, conventional and lower). Additional bipolar montages were constructed offline to measure SCM contraction strength using closely-spaced electrode pairs (bipolar montages: superior, lower and outer). RESULTS: The conventional montage generally produced the largest cVEMP amplitudes (P < 0.001). SCM contraction strength was larger for referential montages than bipolar ones (P < 0.001). Inter-side electrode position errors produced large variations in cVEMP and SCM contraction strength asymmetries in some subjects, producing erroneous abnormal test results. CONCLUSION: Recording locations affect cVEMP amplitude and SCM contraction strength. In most cases, small changes in electrode position had only minor effects but, in a minority of subjects, the different montages produced large changes in cVEMP and contraction amplitudes and asymmetry, potentially affecting test outcomes.

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