cVEMP Test Results Research Articles

Assessment of Sacculocollic and Vestibulomasseteric Reflex Pathways in Individuals With Migraine and Vestibular Migraine.

The study's objective was to evaluate the functioning of sacculocollic and vestibulomasseteric reflex pathways in individuals with vestibular migraine and migraine. Seventy-five participants aged 18-50 years were selected for the study. Participants were divided into three groups. Group 1 consisted of 25 healthy individuals, Group 2 consisted of 25 migraine individuals, and Group 3 consisted of 25 individuals with vestibular migraine. Cervical vestibular-evoked myogenic potential (cVEMP) and masseter vestibular-evoked myogenic potential (mVEMP) were recorded using a 500-Hz tone burst stimulus presented at 125 dB peSPL for all participants. The cVEMP test results showed a delayed p13 and n23 latency for both migraine and vestibular migraine individuals when compared to healthy individuals. Also, the amplitude of the p13-n23 peak was reduced compared to healthy individuals in both migraine and vestibular migraine. Similarly, the mVEMP test results showed a delayed p11 and n21 latency for both migraine and vestibular migraine individuals. No difference was observed in the amplitude of the p11-n21 peak complex between the three groups. Spearman's rho correlation revealed no significant (p > .05) correlation between cervical and masseter VEMP latency and amplitude parameters between healthy, migraine, and vestibular migraine individuals. The results of the study are suggestive of the pathology of the sacullocollic and vestibulomasseteric reflex pathways in individuals with migraine and vestibular migraine. Individuals with migraine and vestibular migraine should undergo a detailed vestibular evaluation.

Audio-vestibular dysfunction in rheumatoid arthritis: An undervalued extra-articular feature

Objective: The study objective was to assess vestibular system either peripherally or centrally in patients with rheumatoid arthritis (RA) using video-nystagmography (VNG) and cervical vestibular-evoked myogenic potentials (cVEMP) in an Egyptian group of RA patients and to study whether there is a correlation between hearing levels, VNG, and cVEMP test results. Materials and Methods: This study was a comparative cross-sectional study. A total of forty individuals (twenty apparently healthy controls [40 ears] and twenty RA patients previously diagnosed by a rheumatologist [40 ears]) were included in the study. RA patients were recruited from the Rheumatology and Internal Medicine Departments of Zagazig University Hospitals. All participants gave their written consent before participation in the study. All participants in the study were subjected to basic audiological evaluation and vestibular evaluation (cVEMP-VNG). Results: There was a highly significant difference in VEMP latencies between RA patients and controls (P 0.05). There was no statistically significant difference in VEMP latencies and amplitude between males and females of the study group (P > 0.05). There was a nonsignificant difference between VEMP latencies and amplitudes among subgroups A and B. All RA patients showed absence of spontaneous gaze-evoked positional and positioning nystagmus, normal oculomotor test, and unilateral caloric weakness in 12 ears. Conclusion: The findings of the current study add more evidence to the cochlea–vestibular involvement in patients with RA. Audio-vestibular function assessment is highly recommended for all RA patients as a routine examination.

Detection of Saccular Endolymphatic Hydrops in Ménière's Disease Using a Modified Glycerol cVEMP Test in Combination With the Tuning Property Test.

To determine the optimal method for detecting saccular endolymphatic hydrops (EH) in patients with Ménière's disease (MD) using a glycerol cervical vestibular evoked myogenic potential (cVEMP) test in combination with a tuning property test. Prospective patients series. Tertiary referral center. Twenty-three subjects (age: 36-77 years) were enrolled in this study. Seventeen subjects were diagnosed with definite MD. Six subjects were diagnosed with possible MD. Diagnostic. The corrected amplitudes of p13-n23 (cVEMP) were measured before and after the administration of 10% glycerol (500 ml, 2 h, intravenously). A tuning property index and the p13-n23 amplitude improvement ratio were calculated. The positivity rate (PR) during the tuning property test was 55% (definite MD-affected ears), 35% (definite MD-unaffected ears), and 25% (possible MD ears). The PR during the glycerol cVEMP amplitude test was 60, 8, and 0%, respectively. The use of modified criteria for the glycerol cVEMP test in combination with the tuning property test resulted in the PR increasing to 75, 57, and 25%, respectively. The pre-glycerol stage results obtained using the tuning property test almost (except in two ears) completely agreed with the glycerol cVEMP test results by the modified criteria. The tuning property test is an easy and useful way of detecting saccular EH. However, the glycerol cVEMP test is required in patients that do not respond to either 500 or 1000 Hz short tone bursts (STB).

Registering grades of sudden deafness to predict the hearing outcome via an inner-ear test battery

Objectives: An inner ear test battery comprising audiometry and ocular vestibular-evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests was applied to patients with sudden deafness to map their lesions and predict hearing outcome. Design: Retrospective study. Study sample: Seventy-five patients with unilateral sudden deafness underwent an inner-ear test battery. Registering the grades of sudden deafness was based on the number of abnormal test results in the inner ear test battery. Results: After treatment for three consecutive months, mean hearing gain declined significantly from Grade I (one abnormal test) to Grade IV (four abnormal tests). Significant relations existed between hearing outcome and oVEMP test results (p < 0.05), caloric test results (p < 0.05), but not cVEMP test results and pre-treatment mean hearing level. Combined caloric and oVEMP test results demonstrated a stronger predictor with a c statistic of 0.722 than either test alone, indicating that this regression model fits the whole set of observations well and is effective in predicting the hearing outcome. Conclusion: Abnormal caloric and oVEMP test results in sudden deafness patients may indicate poor prognosis for hearing improvement, whereas hearing recovery can be anticipated when both tests reveal normal responses.

Ocular and Cervical Vestibular-Evoked Myogenic Potentials in Tumarkin Falls

This study applied ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) tests in Ménière's patients with Tumarkin falls to investigate the etiologic role of the saccule/utricle in the event of Tumarkin falls. Retrospective study. University hospital. Twenty unilateral definite Ménière's patients were divided into 2 age- and sex-matched groups. Ten patients had a history of drop attacks, and 10 had no history of drop attacks. All patients underwent audiometry and caloric, oVEMP, and cVEMP tests. No significant differences were observed between the fall and nonfall groups in terms of Ménière staging, and caloric and cVEMP test results. In the fall group, oVEMP test via Fz tapping showed augmented, reduced, and absent responses in 1, 1, and 8 patients, respectively. In 3 of the latter 8 patients, however, oVEMPs could be obtained by lateral mastoid tapping. Thus, 100% of patients in the fall group had abnormal oVEMPs, which significantly differed from 50% oVEMP abnormalities in the nonfall group. Comparison of the abnormal results for the caloric, oVEMP, and cVEMP tests revealed that poorer residual vestibular function in the fall group than the nonfall group. Absence of oVEMP by Fz tapping and presence of oVEMPs via lateral tapping indicates a residual utricular function. With residual canal function (canal paresis) and absent cVEMPs, subsequently residual utricular function may trigger the Tumarkin falls in Ménière's patients.

Vestibular-evoked myogenic potential tests in orthostatic dizziness

As otolithic control of blood pressure has been the focus of recent interest, this study investigated the ocular and cervical vestibular-evoked myogenic potential (oVEMP and cVEMP) tests in patients with orthostatic dizziness. Sixty patients with orthostatic dizziness and 20 normal controls were consecutively enrolled. All subjects received a battery of tests including audiometry, and caloric, oVEMP and cVEMP tests. Audiometry revealed normal hearing in all 60 patients. Caloric test identified hyperactive and normal responses in 35 and 65% of patients, respectively. The oVEMP test showed normal responses in 36 patients, and abnormal (absent and reduced) responses in 24 patients (40%). Most patients (22/24) with abnormal oVEMPs revealed asymmetrical responses. For the cVEMP test, 30 patients (50%) had normal responses, and 23 and 7 patients showed delayed and absent cVEMPs, respectively. Significant differences existed in the abnormal percentage of oVEMP and cVEMP tests between the patient and control groups. When the oVEMP and cVEMP test results were combined, the abnormal rate increased to 70% of the patients, resulting in stronger association as an elevated odds ratio of 13.2, greater than 12.7 and 5.7 in the corresponding individual oVEMP and cVEMP tests. Patients with orthostatic dizziness may show asymmetric oVEMPs and abnormal (delayed) cVEMPs. If both test results were combined together, a high abnormality (70%) was obtained, indicating that in addition to conventional autonomic test battery, the two VEMP tests may serve as a supplementary tool for evaluating orthostatic dizziness.

Augmentation of Ocular Vestibular‐Evoked Myogenic Potentials via Bone‐Conducted Vibration Stimuli in Ménière Disease

The asymmetry ratio of ocular vestibular-evoked myogenic potential (oVEMP) >40% is interpreted as augmented or reduced response depending on whether the nI-pI amplitude of the lesion ear is larger or smaller than that of the opposite ear, respectively. This study compared unilateral Ménière disease patients with augmented oVEMPs vs reduced oVEMPs to elucidate the mechanism of augmented oVEMP. Case series with chart review. University hospital. Forty patients with unilateral definite Ménière disease were enrolled in this study, including 20 patients with augmented oVEMPs and another 20 patients with reduced oVEMPs in the hydropic side. All patients underwent audiometry, caloric test, and oVEMP and cervical VEMP (cVEMP) tests via bone-conducted vibration stimuli. Then, the oVEMP and cVEMP test results were compared with the stage of Ménière disease, respectively. The augmented group had earlier nI and pI latencies and larger nI-pI amplitude of oVEMPs compared with the reduced group. Caloric test also revealed a significant difference in abnormal responses between the augmented and reduced groups. However, both groups did not differ significantly in the abnormal percentage of cVEMP test results. A significant trend to decline in the prevalence of augmented oVEMPs was noted from stages I to III-IV but not in that of abnormal cVEMPs. The augmented oVEMPs have earlier latencies and larger amplitudes compared with the reduced oVEMPs, indicating that a relatively larger population of intact utricular afferents is activated during the early stage of Ménière disease.

Correlation between caloric and ocular vestibular evoked myogenic potential test results

Conclusion: The ocular vestibular evoked myogenic potential (o-VEMP) test results correlate significantly with caloric test results for patients with acoustic neuroma (AN), but not for patients with Meniere's disease (MD), indicating that the o-VEMP test may replace the caloric test for evaluating the vestibular nerve from which the AN arises. Conversely, the caloric, o-VEMP, and cervical VEMP (c-VEMP) tests should be performed to map lesion sites in the vestibular labyrinth. Objective: This study performed caloric, o-VEMP, and c-VEMP tests on patients with central and peripheral vestibular disorders to investigate their relationships. Methods: In all, 66 patients comprising 16 with unilateral AN and 50 with unilateral definite MD were enrolled. All patients underwent caloric, o-VEMP, and c-VEMP tests. Results: In the AN group, the caloric test identified canal paresis and caloric areflexia in 10 ears, while the o-VEMP and c-VEMP tests identified abnormal (absent or delayed) responses in 12 and 11 ears, respectively. A significant correlation existed between caloric and o-VEMP test results, but not between caloric and c-VEMP test results, or between o-VEMP and c-VEMP test results. For the MD group, abnormal caloric, o-VEMP, and c-VEMP test results were obtained for 24%, 44%, and 38% of hydropic ears, respectively. No correlation existed between any two test results.