Vestibular evoked myogenic potentials in response to skull taps for patients with vestibular neuritis

In recent years it has been demonstrated that loud clicks generate short latency vestibular evoked myogenic potentials (VEMP). It has also been demonstrated that skull tap stimulation evokes similar VEMP. In the present study, the differences between the click-induced and the skull-tap induced VEMP were studied in 18 patients at onset of vestibular neuritis. Gentle skull taps were delivered manually above each ear on the side of the skull and on the forehead midline. The muscular responses were recorded over both sternocleidomastoid muscles using skin electrodes. Abnormal skull tap VEMP were found in the majority of the patients (10/18, 56%). However, only 4/18 (22%) showed asymmetry in the click-induced VEMP. The high percentage of abnormal skull tap VEMP might suggest that this response is not only dependent on the inferior division of the vestibular nerve, because the inferior division of this nerve is usually spared in vestibular neuritis. Moreover, the patients with abnormals kull tap VEMP differed from those with normal VEMP in their settings of the subjective visual horizontal with static head tilt in the roll plane. This might suggest that skull tap VEMP are (also) related to utricular function.

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Vestibular evoked myogenic potentials in response to laterally directed skull taps

Journal of Vestibular Research ◽

10.3233/ves-2002-12104 ◽

2002 ◽

Vol 12 (1) ◽

pp. 35-45 ◽

Cited By ~ 2

Author(s):

Krister Brantberg ◽

Arne Tribukait

Keyword(s):

Vestibular Function ◽

Normal Subjects ◽

Short Latency ◽

The Other ◽

Vestibular Evoked Myogenic Potentials ◽

Vestibular Loss ◽

Skin Electrodes ◽

Function Loss ◽

Relaxation Responses ◽

Muscular Responses

In recent years it has been demonstrated that loud clicks generate short latency vestibular evoked myogenic potentials (VEMP). It has also been demonstrated that midline forehead skull tap stimulation evokes similar VEMP. In the present study, the influence of skull tap direction on VEMP was studied in 13 normal subjects and in five patients with unilateral vestibular loss. Gentle skull taps were delivered manually above each ear on the side of the skull. The muscular responses were recorded over both sternocleidomastoid muscles using skin electrodes. Among the normals, laterally directed skull taps evoked “coordinated contraction-relaxation responses”, i.e. skull taps on one side evoked a negative-positive “inverted” VEMP on that side and a positive-negative "normal" VEMP on the other side. Among patients with unilateral vestibular function loss, skull taps above the lesioned ear evoked similar coordinated contraction-relaxation responses. However, skull taps above the healthy ear did not evoke that type of response. These findings suggest that laterally directed skull taps activate mainly the contralateral labyrinth.

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Ocular and cervical vestibular evoked myogenic potentials in response to bone-conducted vibration in patients with probable inferior vestibular neuritis

The Journal of Laryngology & Otology ◽

10.1017/s0022215112000692 ◽

2012 ◽

Vol 126 (7) ◽

pp. 683-691 ◽

Cited By ~ 20

Author(s):

L Manzari ◽

A M Burgess ◽

I S Curthoys

Keyword(s):

Sense Organ ◽

Vestibular Neuritis ◽

Vestibular Evoked Myogenic Potentials ◽

Detectable Effect ◽

Vestibular Evoked Myogenic Potential ◽

Previous Evidence ◽

Surface Electrodes ◽

Myogenic Potential ◽

Function Testing ◽

Utricular Function

AbstractBackground and aims:Previous evidence shows that the n10 component of the ocular vestibular evoked myogenic potential indicates utricular function, while the p13 component of the cervical vestibular evoked myogenic potential indicates saccular function. This study aimed to assess the possibility of differential utricular and saccular function testing in the clinic, and whether loss of saccular function affects utricular response.Methods:Following vibration conduction from the mid-forehead at the hairline, the ocular n10 component was recorded by surface electromyograph electrodes beneath both eyes, while the cervical p13–n23 component was recorded by surface electrodes over the tensed sternocleidomastoid muscles.Results:Fifty-nine patients were diagnosed with probable inferior vestibular neuritis, as their cervical p13–n23 component was asymmetrical (i.e. reduced or absent on the ipsilesional side), while their ocular n10 component was symmetrical (i.e. normal beneath the contralesional eye).Conclusion:The sense organ responsible for the cervical and the ocular vestibular evoked myogenic potentials cannot be the same, as one response was normal while the other was not. Reduced or absent saccular function has no detectable effect on the ocular n10 component. On vibration stimulation, the ocular n10 component indicates utricular function and the cervical p13–n23 component indicates saccular function.

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Ocular vestibular-evoked myogenic potentials to bone-conducted vibration in superior vestibular neuritis show utricular function

Otolaryngology ◽

10.1016/j.otohns.2010.03.020 ◽

2010 ◽

Vol 143 (2) ◽

pp. 274-280 ◽

Cited By ~ 66

Author(s):

Leonardo Manzari ◽

AnnaRita Tedesco ◽

Ann M. Burgess ◽

Ian S. Curthoys

Keyword(s):

Vestibular Neuritis ◽

Vestibular Evoked Myogenic Potentials ◽

Utricular Function

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Utricular function in vestibular neuritis: a pilot study of concordance/discordance between ocular vestibular evoked myogenic potentials and ocular cycloposition

Experimental Brain Research ◽

10.1007/s00221-019-05529-8 ◽

2019 ◽

Vol 237 (6) ◽

pp. 1531-1538 ◽

Cited By ~ 4

Author(s):

Marcello Cherchi

Keyword(s):

Pilot Study ◽

Vestibular Neuritis ◽

Vestibular Evoked Myogenic Potentials ◽

Utricular Function

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Vestibular Neuritis (Neurolabyrinthitis) and Other Peripheral Vestibulopathies: Detection of Inferior Vestibular Nerve Damage

Vestibular Evoked Myogenic Potential ◽

10.1007/978-4-431-85908-6_7 ◽

2009 ◽

pp. 60-72

Keyword(s):

Nerve Damage ◽

Vestibular Nerve ◽

Vestibular Neuritis ◽

Inferior Vestibular Nerve

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084 Separating stroke from vestibular neuritis by vestibular function test parameters

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-anzan.72 ◽

2019 ◽

Vol 90 (e7) ◽

pp. A27.1-A27

Author(s):

Zeljka Calic ◽

Benjamin Nham ◽

Rachel Taylor ◽

Allison Young ◽

Craig Anderson ◽

...

Keyword(s):

Three Dimensional ◽

Vestibular Function ◽

Vestibular Neuritis ◽

Vestibular Evoked Myogenic Potentials ◽

Head Impulse Test ◽

Saccade Amplitude ◽

Vestibular Tests ◽

Acute Vestibular Syndrome ◽

Significant Difference ◽

Catch Up

IntroductionVestibular neuritis (VN) and posterior circulation stroke (PCS) are the commonest causes of acute vestibular syndrome (AVS). We aim to identify discriminators of VN from PCS by testing all five vestibular end-organs in patients presenting with AVS.MethodsThree-dimensional video-head impulse test (v-HIT), cervical and ocular-vestibular evoked myogenic potentials (c-and oVEMP) and subjective visual horizontal (SVH) tests were performed in 22 patients with VN and 22 with PCS. Ipsilesional horizontal, anterior and posterior canal (HC, AC, PC) v-HIT gain and first catch-up saccade characteristics, VEMP amplitude asymmetry-ratios were compared.ResultsAll VN and 6 PCS patients had positive clinical HIT. Mean time to testing was 4.7 days for VN, 7.0 days for PCS. VN mean ipsilesional HC and AC first saccade amplitude was larger, peak-velocities faster and onset latencies earlier compared to PCS (p<0.05). No significant difference between VN and PCS in first saccade characteristics was found in PC. Ipsilesional first saccade amplitude, peak-velocity and duration were significantly different between PCS and controls for all canals (p<0.05). A gain <0.68 and first saccade amplitudes >2.2°separated VN from PCS with sensitivities of 95.5% and 86.4% and specificities of 72.7% and 63.6%. First saccade amplitude of >0.91°identified PCS from controls with sensitivity of 68.2% and specificity of 70%. Abnormality rates for AC cVEMP, BC oVEMP and SVH were 42.9%, 50% and 91% for VN and 38.1%, 9% 72% for PCS.Conclusion v-HIT gain and catch-up saccade metrics are useful separators of VN from PCS. Detailed saccade analysis complements existing vestibular tests.

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Vestibular neuritis has selective effects on air- and bone-conducted cervical and ocular vestibular evoked myogenic potentials

Clinical Neurophysiology ◽

10.1016/j.clinph.2010.12.040 ◽

2011 ◽

Vol 122 (6) ◽

pp. 1246-1255 ◽

Cited By ~ 44

Author(s):

Sendhil Govender ◽

Sally M. Rosengren ◽

James G. Colebatch

Keyword(s):

Vestibular Neuritis ◽

Vestibular Evoked Myogenic Potentials ◽

Selective Effects

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Investigating short latency subcortical vestibular projections in humans: what have we learned?

Journal of Neurophysiology ◽

10.1152/jn.00157.2019 ◽

2019 ◽

Vol 122 (5) ◽

pp. 2000-2015 ◽

Cited By ~ 2

Author(s):

James G. Colebatch ◽

Sally M. Rosengren

Keyword(s):

Brain Stem ◽

Physiological Role ◽

Vestibular Function ◽

Short Latency ◽

Vestibular Evoked Myogenic Potentials ◽

Ocular Vemp ◽

Motor Unit Firing ◽

Cervical Vemp ◽

Noninvasive Assessment

Vestibular evoked myogenic potentials (VEMPs) are now widely used for the noninvasive assessment of vestibular function and diagnosis in humans. This review focuses on the origin, properties, and mechanisms of cervical VEMPs and ocular VEMPs; how these reflexes relate to reports of vestibular projections to brain stem and cervical targets; and the physiological role of (otolithic) cervical and ocular reflexes. The evidence suggests that both VEMPs are likely to represent the effects of excitation of irregularly firing otolith afferents. While the air-conducted cervical VEMP appears to mainly arise from excitation of saccular receptors, the ocular VEMP evoked by bone-conducted stimulation, including impulsive bone-conducted stimuli, mainly arises from utricular afferents. The surface responses are generated by brief changes in motor unit firing. The effects that have been demonstrated are likely to represent otolith-dependent vestibulocollic and vestibulo-ocular reflexes, both linear and torsional. These observations add to previous reports of short latency otolith projections to the target muscles in the neck (sternocleidomastoid and splenius) and extraocular muscles (the inferior oblique). New insights have been provided by the investigation and application of these techniques.

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