Vestibular Evoked Myogenic Potentials versus Vestibular Test Battery in Patients with Ménière’s Disease (original) (raw)
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The Follow-Up Role of the Vestibular Evoked Myogenic Potential Test in Meniere's Disease
Acta medica Iranica, 2018
Despite some proposed roles for the diagnostic impact of the cervical vestibular evoked myogenic potential test in the patients with Meniere's disease, the role of this test as an objective instrument in following up the patients with Meniere's disease who underwent. Intratympanic steroid injection is not cleared. In a prospective study, thirty-one adult patients with definite one-sided Meniere's disease with vertigo as main complaint refractory to medical treatments for three months, were selected. Patients underwent three times of intratympanic dexamethasone injection with one-week intervals. We performed cervical vestibular evoked myogenic potential test at first and four weeks after the last injection for all participants. We followed the patients for one year. The study results were analyzed with the chi-square test. Cervical vestibular evoked myogenic potential test could not be recorded in 26 patients (83.9%), and the test results were abnormal in the remaining 5 ...
Utility of Vestibular Evoked Myogenic Potentials in the Diagnosis of Meniere’s Disease: A Review
Journal of Hearing Science, 2013
Meniere’s disease is an inner ear disorder characterized by aural fullness, spontaneous attacks of vertigo, fluctuating low-frequency sensorineural hearing loss and tinnitus. There are various tests such as puretone audiometry, electrocochleography, glycerol test, Caloric test, Cochlear hydrops analysis masking which have been utilised in diagnosing the Meniere’s disease. Recently cervical vestibular evoked myogenic potentials and ocular vestibular myogenic potentials have been utilised to measure the functioning of the sacculocollic and otolith ocular pathway respectively. The objective of the present study is to provide an overview of the cervical and ocular vestibular evoked myogenic potentials tests findings in individuals with Meniere’s disease.
Clinical and experimental otorhinolaryngology, 2013
Our goal was to find the clinical value of cervical vestibular evoked myogenic potential (VEMP) in Ménière's disease (MD) and to evaluate whether the VEMP results can be useful in assessing the stage of MD. Furthermore, we tried to evaluate the clinical effectiveness of VEMP in predicting hearing outcomes. The amplitude, peak latency and interaural amplitude difference (IAD) ratio were obtained using cervical VEMP. The VEMP results of MD were compared with those of normal subjects, and the MD stages were compared with the IAD ratio. Finally, the hearing changes were analyzed according to their VEMP results. In clinically definite unilateral MD (n=41), the prevalence of cervical VEMP abnormality in the IAD ratio was 34.1%. When compared with normal subjects (n=33), the VEMP profile of MD patients showed a low amplitude and a similar latency. The mean IAD ratio in MD was 23%, which was significantly different from that of normal subjects (P=0.01). As the stage increased, the IAD r...
Otology & Neurotology, 2019
The cervical vestibular evoked myogenic potential (cVEMP) has been used to evaluate patients with Meniere's Disease (MD). Studied cVEMP metrics include: amplitude, threshold, frequency tuning and interaural asymmetry ratio (IAR). However, few studies compared these metrics in the same set of MD patients, and methodological differences prevent such a comparison across studies. This study investigates the value of different cVEMP metrics in distinguishing one set of MD patients from age-matched controls. Patients: Thirty patients with definite unilateral MD and twenty-three age-matched controls were prospectively included. All underwent cVEMP testing at 500, 750, 1000 and 2000 Hz on each side. Ears were separated into three groups: affected MD, unaffected MD and control. Main outcome measures: Sound level functions were obtained at each frequency, and normalized peak-to-peak amplitude (VEMPn), VEMP inhibition depth (VEMPid), threshold, frequency-tuning ratio and IAR were calculated. For all metrics, the differentiation between MD and control ears was compared using ROC curves. Results: 500 Hz cVEMP threshold, VEMPn and VEMPid were similarly good at distinguishing affected MD ears from healthy ears, with ROC area under the curves (AUCs) of >0.828 and optimal sensitivities and specificities of at least 80% and 70%. Combinations of these three metrics yielded slightly larger AUCs (>0.880). Tuning ratios and IAR were less effective in separating healthy from affected ears with AUCs ranging from 0.529-0.720.
Objective: Frequency amplitude ratio (FAR) is one among several parameters of cervical vestibular evoked myogenic potential (cVEMP) found useful in diagnosis of Meniere’s disease. This being the least explored of the parameters, there is not only a need for further investigation but also a need for identifying the best suited frequency amplitude ratio for diagnosing Meniere’s disease. Design: This prospective study aimed at investigating FAR of cVEMP in healthy individuals and individuals with Meniere’s disease establishing the optimum frequency pair for assessment of Meniere’s disease. Study sample: Twenty two individuals with unilateral definite Meniere’s disease were compared against 22 healthy individuals. Results: Frequency amplitude ratios corresponding to 750/500, 1000/500, 1500/500 and tuned frequency/500 were all found useful in diagnosis of Meniere’s disease by virtue of showing larger frequency amplitude ratio in Meniere’s disease ears compared to the controls (p< 0.05...
Usefulness of vestibular evoked myogenic potentials in diagnosis of peripheral vestibular disorders
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: Vestibular evoked myogenic potentials (VEMP) are electromyographic responses to high-intensity acoustic stimuli to test vestibular system, otolith function and integrity of inferior vestibular nerve. These are easy to perform and non-invasive. In this study, we aimed at clinical application of VEMP to evaluate common peripheral vestibular disorders.Methods: Prospective observational study carried in ENT department during January 2015-November 2016 over 40 patients in age group between 30-70 years with history of vertigo who underwent regular neuro-otological examination and VEMP.Results: Of these, 25 diagnosed with BPPV, 11 with Meniere’s disease, and four with vestibular neuritis. Eight patients showed delayed VEMP responses. 28 (70%) patients had normal VEMP, 12 (30%) had abnormal VEMP responses. Out of 25 patients suffering from benign paroxysmal positional vertigo (BPPV) posterior semi-circular canal was involved in 20 (80%) patients and lateral semi-circular canal i...
Brazilian journal of otorhinolaryngology, 2016
The vestibular evoked myogenic potential is a potential of mean latency that measures the muscle response to auditory stimulation. This potential can be generated from the contraction of the sternocleidomastoid muscle and also from the contraction of extraocular muscles in response to high-intensity sounds. This study presents a combined or simultaneous technique of cervical and ocular vestibular evoked myogenic potential in individuals with changes in the vestibular system, for use in otoneurologic diagnosis. To characterize the records and analyze the results of combined cervical and ocular VEMP in individuals with vestibular hyporeflexia and in those with Ménière's disease. The study included 120 subjects: 30 subjects with vestibular hyporeflexia, 30 with Ménière's disease, and 60 individuals with normal hearing. Data collection was performed by simultaneously recording the cervical and ocular vestibular evoked myogenic potential. There were differences between the study ...
Hearing, Balance and Communication, 2019
Objectives: To describe the vestibular evoked myogenic potential (VEMP) response to air-conducted sound (ACS) and bone-conducted vibration (BCV) in patients with unilateral definite M eni ere's disease (MD), and the contribution to the usual ACS evaluation of the bone-air index (BAI) and interaural asymmetry ratio (IAR) in the diagnosis. Methods: A case-control study was designed. Fifty-one patients (25 men and 26 women) with an average age of 55 years, and 31 healthy volunteers with no history of vertigo and hearing loss, were included. The BAI was used as a new parameter to describe the amplitude of the response. Results: Only n10 latency ACS evoked was significantly longer than in controls. The ACS cVEMP p13-n23 amplitude of the affected ear of patients with MD was lower than in the non-affected ear (p ¼ .023) and the control group (.001). The IAR was significantly higher in patients with MD both for the ACS and for the BCV cVEMP compared to the control group: p ¼ .004 and .001, respectively. Significant differences were found in oVEMP n10-p16 amplitude between ACS and BCV in the patients with MD (p ¼ .002). The BAI in oVEMP showed a significant increase in the affected ear compared to the control group (p ¼ .001). The acoustic stimulus in cVEMP was the only one that showed significant differences in amplitude according to degree of hearing loss (p ¼ .039). Conclusions: The joint use of an acoustic and vibratory stimulus is an interesting option to characterize the results in this group. The BAI provides useful complementary information, and also turns out to give added value to the traditional VEMP assessment by ACS. We recommend its use when M eni ere's disease is suspected.
The clinical reliability of vestibular evoked myogenic potentials
Ear, nose, & throat journal, 2010
Vestibular evoked myogenic potential (VEMP) testing has gained popularity as a diagnostic modality in otolaryngology and audiology. To maximize the utility of this test, examiners need the availability of ideal test settings and reliable norms. We conducted a prospective study of 8 subjects with no history of neurotologic symptoms to examine the test-retest consistency of VEMP testing and to analyze the impact of stimulus type and muscle tension monitoring. All subjects underwent VEMP testing with two stimuli: a 500-Hz tone and a click. With each stimulus, testing was completed with and without monitoring of sternocleidomastoid muscle tension. All subjects participated in an initial testing session and then returned for a repeat testing session 2 to 4 weeks later. We measured the amplitude of primary waveforms P13 (first positive peak) and N23 (first negative peak) and analyzed the reliability and reproducibility of the mean amplitude asymmetry of these VEMP peaks. The P13 component...
ABSTRACT Purpose: The purposes of this study were to investigate the results of contra-lateral ocular vestibular evoked myogenic potentials (OVEMPs) elicited in patients with unilateral definite Ménière’s disease (DMD) in response to monaural tone bursts acoustic stimulation and to compare them with that of the un-affected sides as well as normal subjects. Materials and Method: This study consisted of 31 patients with DMD (13 males and 18 females) and thirty normal subjects (16 females and 14 males) as a control group. They were subjected to hearing assessment and OVEMPs measurements. The biphasic N1, P1 waveform was recorded with respect to latencies in ms and amplitude in μV. In this study OVEMPs differ in the affected than the un-affected side of Ménière’s disease and normal subjects. Results: The results revealed that the mean amplitudes of the contra-lateral oVEMPs in the affected ears were significantly lowers and the mean latencies were significantly longer than that of normal. The average asymmetry ratio was significantly greater in Ménière’s disease patients in comparison to normal subjects. Conclusion: These differences could be attributed to the patho-physiologic mechanism encountered in those patients. Hence, OVEMPs can be used as a part of the diagnostic work up of Ménière’s disease to assess the crossed vestibular evoked potentials in those patients.