VEMP readings - Research and Technology Paper Vestibular...

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Vestibular Evoked Myogenic Potentials 135 American Journal of Audiology Vol. 13 • 135–143 December 2004 © American Speech-Language-Hearing Association 1059-0889/04/1302-0135 Research and Technology Paper Guangwei Zhou Massachusetts Eye and Ear Infirmary, Boston L. Clarke Cox Boston University/Boston Medical Center Vestibular Evoked Myogenic Potentials: History and Overview Vestibular evoked myogenic potential (VEMP) testing is a relatively new diagnostic tool that is in the process of being investigated in patients with specific vestibular disorders. In this review, we will outline the history and provide a current review of VEMP research. Briefly, the VEMP is a biphasic response elicited by loud clicks or tone bursts recorded from the tonically contracted sternocleidomas- toid muscle. Current data suggest that the VEMP is a vestibulo-collic reflex whose afferent limb arises from acoustically sensitive cells in the saccule, with signals conducted via the inferior vestibular nerve. We will review the history of the response and detail the anatomy and physiology associated with the test. We will discuss specific VEMP applications in the diagnosis of Meniere’s disease, vestibular schwannoma, vestibular hypersensitivity disorders, vestibular neuritis, multiple sclerosis, and other brainstem lesions. Key Words: vestibular evoked myogenic potential, sternocleidomastoid muscle, electronystagmography, vestibular-ocular reflex C linical tools for diagnosing vestibular disorders caused by semicircular canal dysfunction are readily available, while tests sensitive to otolith disorders are scarce. During the past few years, there have been studies on vestibular evoked myogenic potentials (VEMPs) in animals and humans. Briefly, the VEMP is an inhibitory potential recorded from the sternocleidomastoid muscle in response to loud sounds. It is thought that VEMPs have a vestibular origin. Evidence in animals and humans have supported saccular generation conducted via the inferior vestibular nerve. Thus VEMP testing may provide a useful, noninvasive method for assessment of otolith function and the functional integrity of the inferior vestibular nerve (Akin, Murnane, & Proffitt, 2003; Al- Abdulhadi, Zeitouni, Al-Sebeih, & Katsarkas, 2002; C. W. Chen, Young, & Wu, 2000; 2003; Colebatch, Halmagyi, & Skuse, 1994; Ferber-Viart, Duclaux, Colleaux, & Dubreuil, 1997; Tomlinson, 1999; McCue & Guinan, 1995; Ochi, Ohashi, & Nishino, 2001; Clinically, the test is relatively easy to perform and can be performed with most evoked potentials recording systems. Complete assessment of vestibular function is an important measurement in neurology, otolaryngology, and audiology. Typical tests used in the electronystagmography (ENG) battery only assess lateral semicircular canals and the superior vestibular nerve. By adding VEMP measure- ments, the clinician may have the capability of revealing
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This note was uploaded on 04/11/2010 for the course AUD 831 taught by Professor Drlisakoch during the Spring '10 term at A.T. Still University.

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VEMP readings - Research and Technology Paper Vestibular...

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