Abstract
Ocular vestibular evoked myogenic potentials (oVEMPs), subjective visual vertical (SVV), and fundus photographically measured binocular cyclorotation (BCR) are diagnostic tests to assess utricular function in patients with vertigo or dizziness. In 138 patients with chronic vertigo or dizziness, we asked whether the asymmetry ratio of oVEMP (normal, right side pathological, left side pathological) could predict the SVV deviation (normal, rightward deviation, leftward deviation) or BCR (normal, cyclorotation to the right, cyclorotation to the left). There was no correlation between oVEMP and SVV and between oVEMP and BCR, while SVV and BCR correlated highly. Although both oVEMP and SVV measure aspects of utricular function, our findings demonstrate that oVEMP and SVV are not redundant and may reflect different utricular pathologies. The role of fundus photographic BCR may be relegated to only confirm unclear SVV results in vestibular diagnostic workup.
Highlights
In patients with vertigo or dizziness, it is common to apply a comprehensive battery of auxiliary tests that help identify underlying disorders within the vestibular labyrinth, the vestibular nerve, or central vestibular networks
We explored whether compensated subjective visual vertical (SVV) and binocular cyclorotation (BCR) together with remaining ocular vestibular evoked myogenic potentials (VEMPs) (oVEMPs) asymmetry are common patterns in chronic vertigo patients
This study shows that in an unselected sample of patients with vertigo or dizziness, oVEMP results were not predictive of SVV results or BCR results
Summary
In patients with vertigo or dizziness, it is common to apply a comprehensive battery of auxiliary tests that help identify underlying disorders within the vestibular labyrinth, the vestibular nerve, or central vestibular networks. These vestibular tests include assessments of both semicircular canal and otolith functions [1]. While VEMPs are elicited by dynamic stimulation (vibration or sound) of utricular (ocular VEMPs) or saccular (cervical VEMPs) hair cells, SVV and BCR reflect the orientation of the sensed static gravito-inertial vector relative to the head in the coronal plane [2,3,4]. While the readout of oVEMP and BCR is eye position, SVV is a psychophysical measure of the perceived earthvertical, which subjects indicate by orienting a luminous line in otherwise complete darkness
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