Abstract
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.
Highlights
Vestibular-dependent myogenic responses to intense sound were first described by Bickford et al, in 1964 [1]
This study presents normative values of Vestibular-evoked myogenic potentials” (VEMP) parameters using the authors’ protocol
There was no difference between VEMP parameters of the right and the left ear
Summary
Vestibular-dependent myogenic responses to intense sound were first described by Bickford et al, in 1964 [1]. In 1995, Halmagyi and Colebatch reported the responses that were not of lateral canal origin and the term “Vestibular-evoked myogenic potentials” (VEMP) has been widely used since [3]. VEMP assesses vestibular function through the vestibulocollic reflex (VCR). The VCR arc includes the receptor (the saccule), the afferent pathway (the inferior vestibular nerve), and the efferent pathway (the lateral vestibulospinal tract, the medial vestibulospinal tract, and the end muscle) [4]. Electronystagmography (ENG) is a gold standard vestibular function test. The caloric test induces vertigo and assesses only the horizontal semicircular canal function [5]. Compared to the ENG, VEMP testing is easier to perform, less complicated for interpretation, induces less dizziness or nausea, and is more tolerable to patients [6]
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