Ocular vestibular evoked myogenic potentials produced by impulsive lateral acceleration in unilateral vestibular dysfunction

2011 ◽  
Vol 122 (12) ◽  
pp. 2498-2504 ◽  
Author(s):  
Sendhil Govender ◽  
Sally M. Rosengren ◽  
Neil P. McAngus Todd ◽  
James G. Colebatch
Keyword(s):  
Vestibular Dysfunction ◽  
Lateral Acceleration ◽  
Vestibular Evoked Myogenic Potentials

scholarly journals Assessment of cervical and ocular vestibular evoked myogenic potentials in migraine patients

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Doaa Elmoazen ◽  
Hesham Kozou ◽  
Jaidaa Mekky ◽  
Dalia Ghanem
Keyword(s):  
Vestibular Function ◽  
Vestibular Dysfunction ◽  
Peak Amplitude ◽  
Vestibular Evoked Myogenic Potentials ◽  
Healthy Controls ◽  
Latency Difference ◽  
Significant Difference ◽  
Cervical Vemp ◽  
Vestibular Symptoms ◽  
Function Assessment

Abstract Background Patients suffering from vestibular migraine (VM) are known to have various vestibular test abnormalities interictally and ictally. Recently, vestibular evoked myogenic potentials (VEMPs) have become accepted as a valid method for otolith function assessment. Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Since migraineurs with no accompanying vestibular symptoms might exhibit subclinical vestibular dysfunction, we investigated vestibular function using ocular and cervical VEMPs in migraine patients. The aim was to study cervical VEMP and occular VEMP in migraineurs with and without vestibular symptoms interictally. Results Migraine and VM patients showed significantly longer P13 latency of cVEMP compared to controls. A statistically significant cVEMP interaural P13 latency difference was found in VM compared to healthy controls. Cervical VEMP N23 latency, peak-to-peak amplitude, interaural N23 latency, and amplitude asymmetric ratio did not show any significant difference in migraine and VM patients compared to healthy controls as well as no significant difference across the three groups regarding oVEMP parameters. Conclusions Abnormal interictal cVEMP results in migraineurs might indicate subclinical vestibulo-collic pathway dysfunction.

Vestibular-dependent spinal reflexes evoked by brief lateral accelerations of the heads of standing subjects

2012 ◽  
Vol 112 (11) ◽  
pp. 1906-1914 ◽  
Author(s):  
Robyn Laube ◽  
Sendhil Govender ◽  
James G. Colebatch
Keyword(s):  
Head Rotation ◽  
Vestibular Dysfunction ◽  
Spinal Reflexes ◽  
Lateral Acceleration ◽  
Initial Interval ◽  
Eyes Closed ◽  
Long Latency ◽  
Long Duration ◽  
Closed Head ◽  
Biphasic Responses

An impulsive acceleration stimulus, previously shown to activate vestibular afferents, was applied to the mastoid. Evoked EMG responses from the soleus muscles in healthy subjects ( n = 10) and patients with bilateral vestibular dysfunction ( n = 3) were recorded and compared with the effects of galvanic stimulation (GVS). Subjects were stimulated while having their eyes closed, head rotated, and while tonically activating their soleus muscles. Rectified EMG responses were recorded from the leg contralateral to the direction of head rotation. Responses were characterized by triphasic potentials that consisted of short-latency (SL), medium-latency (ML), and long-latency (LL) components beginning at (mean ± SD) 54.2 ± 4.8, 88.4 ± 4.7, and 121 ± 7.1 ms, respectively. Mean amplitudes for the optimum stimulus rise times were 9.05 ± 3.44% for the SL interval, 16.70 ± 4.41% for the ML interval, and 9.75 ± 4.89% for the LL interval compared with prestimulus values. Stimulus rise times of 14 and 20 ms evoked the largest ML amplitudes. GVS evoked biphasic responses (SL and ML) with similar latencies. Like GVS, the polarity of the initial interval was determined by the polarity of the stimulus and the evoked EMG response was attenuated when subjects were seated. There was no significant EMG response evoked when subjects were stimulated using 500-Hz vibration or in patients with bilateral vestibular dysfunction. Our study demonstrates that a brief lateral acceleration, likely to activate the utricle, can evoke spinal responses with properties similar to those previously shown for vestibular activation by GVS. The triphasic nature of the responses may allow the nervous system to respond differently to short compared with long-duration linear accelerations, consistent with their differing significance.

scholarly journals Vestibular evoked myogenic potentials evoked by brief interaural head acceleration: properties and possible origin

2009 ◽  
Vol 107 (3) ◽  
pp. 841-852 ◽  
Author(s):  
Sally M. Rosengren ◽  
Neil P. M. Todd ◽  
James G. Colebatch
Keyword(s):  
Positive Response ◽  
Normal Subjects ◽  
Lateral Acceleration ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Acceleration ◽  
Vestibular Evoked Myogenic Potential ◽  
Side Peak ◽  
Vestibular Loss ◽  
Intact Side ◽  
Late Positivity

The vestibular system responds to head acceleration by producing compensatory reflexes in the eyes and postural muscles. In this study, we investigated the effect of brief interaural acceleration on the vestibular evoked myogenic potential (VEMP) in 10 normal subjects and 10 patients with bilateral (bVL) or unilateral vestibular loss (uVL). The stimuli were delivered with a handheld minishaker and tendon hammer over the mastoid and produced relatively pure interaural head acceleration with little rotation (mean peak acceleration: 0.14 g at 3.3 ms). VEMPs were recorded from the neck muscles and were characterized in normal subjects by a positive/negative potential ipsilateral to the stimulated side (peak latencies: 15.1 and 22.6 ms) and a positive response contralaterally (20.3 ms), which was sometimes preceded by a negativity (14.5 ms). These peaks were absent in patients with bVL, confirming their vestibular dependence. In the patients with uVL, medial acceleration of the intact ear produced bilateral responses, an initial positivity on the intact side, and a negativity on the affected side, whereas lateral acceleration produced only a late positivity on the intact side. As the acceleration was primarily in the horizontal plane, it is likely to have activated utricular receptors. Consistent with this, we found that VEMPs are very sensitive to the direction of head acceleration and have features consistent with the utriculocollic projections demonstrated in animals.

scholarly journals Vestibular Infant Screening (VIS)–Flanders: results after 1.5 years of vestibular screening in hearing-impaired children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sarie Martens ◽  
Ingeborg Dhooge ◽  
Cleo Dhondt ◽  
Saartje Vanaudenaerde ◽  
Marieke Sucaet ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Participation Rate ◽  
Vestibular Dysfunction ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Vestibular Evoked Myogenic Potentials ◽  
Infant Screening ◽  
Impaired Children ◽  
Hearing Impaired Children

AbstractDue to the close anatomical relationship between the auditory and vestibular end organs, hearing-impaired children have a higher risk for vestibular dysfunction, which can affect their (motor) development. Unfortunately, vestibular dysfunction often goes unnoticed, as vestibular assessment in these children is not standard of care nowadays. To timely detect vestibular dysfunction, the Vestibular Infant Screening–Flanders (VIS–Flanders) project has implemented a basic vestibular screening test for hearing-impaired infants in Flanders (Belgium) with a participation rate of 86.7% during the first year and a half. The cervical Vestibular Evoked Myogenic Potentials (cVEMP) test was applied as vestibular screening tool to map the occurrence of vestibular (mainly saccular) dysfunction in this population. At the age of 6 months, 184 infants were screened. No refers on vestibular screening were observed in infants with permanent conductive hearing loss. In infants with permanent sensorineural hearing loss, a cVEMP refer rate of 9.5% was observed. Failure was significantly more common in infants with severe-profound compared to those with mild-moderate sensorineural hearing loss (risk ratio = 9.8). Since this is the first regional study with a large sample size and successful participation rate, the VIS–Flanders project aims to set an example for other regions worldwide.

Vestibular dysfunction in patients with auditory neuropathy detected by vestibular evoked myogenic potentials

2020 ◽  
Vol 131 (7) ◽  
pp. 1664-1671 ◽  
Author(s):  
Juan Hu ◽  
Zichen Chen ◽  
Yuzhong Zhang ◽  
Yong Xu ◽  
Weijun Ma ◽  
...  
Keyword(s):  
Vestibular Dysfunction ◽  
Auditory Neuropathy ◽  
Vestibular Evoked Myogenic Potentials

The lesion site of vestibular dysfunction in Ramsay Hunt syndrome: A study by click and galvanic VEMP

2007 ◽  
Vol 16 (4-5) ◽  
pp. 217-222
Author(s):  
Hidenori Ozeki ◽  
Shinichi Iwasaki ◽  
Munetaka Ushio ◽  
Naonobu Takeuchi ◽  
Toshihisa Murofushi
Keyword(s):  
Semicircular Canal ◽  
Vestibular Dysfunction ◽  
Vestibular Nerve ◽  
Vestibular Evoked Myogenic Potentials ◽  
Lesion Site ◽  
Lateral Semicircular Canal ◽  
Caloric Testing ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Vestibular Symptoms

Ramsay Hunt syndrome (RHS) is characterized by vestibulocochlear dysfunction in addition to facial paralysis and auricular vesicles. The present study investigated the lesion site of vestibular dysfunction in a group of 10 RHS patients. Caloric testing, vestibular evoked myogenic potentials by click sound (cVEMP) and by galvanic stimulation (gVEMP) were used to assess the function of the lateral semicircular canal, saccule, and their afferents. The results of caloric testing (all 10 cases showed canal paresis) mean the existence of lesion sites in lateral semicircular canal and/or superior vestibular nerve (SVN). Abnormal cVEMPs in 7 patients mean the existence of lesions in saccule and/or inferior vestibular nerve (IVN). Four of the 6 patients with absent cVEMP also underwent gVEMP. The results of gVEMP (2 absent and 2 normal) mean that the former 2 have lesions of the vestibular nerve, and the latter 2 have only saccular lesions concerning the pathway of VEMPs. Thus, our study suggested that lesion sites of vestibular symptoms in RHS could be in the vestibular nerve and/or labyrinth, and in SVN and/or IVN. In other words, in the light of vestibular symptoms, there is the diversity of lesion sites.

scholarly journals Long-Term Vestibular Outcomes in Cochlear Implant Recipients

2021 ◽  
Vol 12 ◽  
Author(s):  
Kasper Møller Boje Rasmussen ◽  
Niels West ◽  
Luchen Tian ◽  
Per Cayé-Thomasen
Keyword(s):  
Cochlear Implantation ◽  
Vestibular Function ◽  
Vestibular Dysfunction ◽  
Vestibular Evoked Myogenic Potentials ◽  
Significant Deterioration ◽  
Caloric Irrigation ◽  
Vestibular Tests ◽  
Wide Range

Background: Vestibular dysfunction is likely the most common complication to cochlear implantation (CI) and may, in rare cases, result in persistent severe vertigo. Literature on long-term vestibular outcomes is scarce.Objective: This paper aims to evaluate vestibular dysfunction before and after cochlear implantation, the long-term vestibular outcomes, and follows up on previous findings of 35 consecutive adult cochlear implantations evaluated by a battery of vestibular tests.Methods: A prospective observational longitudinal cohort study was conducted on 35 CI recipients implanted between 2018 and 2019; last follow-up was conducted in 2021. At the CI work-up (T0) and two postoperative follow-ups (T1 and T2), 4 and 14 months following implantation, respectively, all patients had their vestibular function evaluated. Evaluation with a vestibular test battery, involving video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMP), caloric irrigation test, and dizziness handicap inventory (DHI), were performed at all evaluations.Results: vHIT testing showed that 3 of 35 ears had abnormal vHIT gain preoperatively, which increased insignificantly to 4 of 35 at the last follow-up (p = 0.651). The mean gain in implanted ears decreased insignificantly from 0.93 to 0.89 (p = 0.164) from T0 to T2. Preoperatively, 3 CI ears had correction saccades, which increased to 11 at T2 (p = 0.017). Mean unilateral weakness increased from 19 to 40% from T0 to T2 (p < 0.005), and the total number of patients with either hypofunctioning or areflexic semicircular canals increased significantly from 7 to 17 (p < 0.005). Twenty-nine percent of CI ears showed cVEMP responses at T0, which decreased to 14% (p = 0.148) at T2. DHI total mean scores increased slightly from 10.9 to 12.8 from T0 to T1 and remained at 13.0 at T2 (p = 0.368). DHI scores worsened in 6 of 27 patients and improved in 4 of 27 subjects from T0 to T2.Conclusion: This study reports significant deterioration in vestibular function 14 months after cochlear implantation, in a wide range of vestibular tests. vHIT, caloric irrigation, and cVEMP all measured an overall worsening of vestibular function at short-term postoperative follow-up. No significant deterioration or improvement was measured at the last postoperative follow-up; thus, vestibular outcomes reached a plateau. Despite vestibular dysfunction, most of the patients report less or unchanged vestibular symptoms.

Sports Concussions (TBI), Imbalance, and Dizziness

2015 ◽  
Vol 25 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Steven M. Doettl
Keyword(s):  
Assessment Tools ◽  
Vestibular Evoked Myogenic Potentials ◽  
Post Injury ◽  
Management Tools ◽  
Concussion Management ◽  
Post Concussion Syndrome ◽  
Behavioral Marker ◽  
Valid Assessment ◽  
Injury Assessment

It has been widely accepted that the assessment of balance after concussion plays a large role in determining deficit. Qualitative balance assessments have been an established piece of the post-injury assessment as a clinical behavioral marker of concussion for many years. Recently more specific guidelines outlining the role of balance evaluation in concussion identification and management have been developed as part of concussion management tools. As part of the ongoing development of concussions protocols, quantitative assessment of balance function following concussion has also been identified to have an important role. Frequently imbalance and dizziness reported following concussion is assumed to be associated with post-concussion syndrome (PCS). While imbalance and dizziness are common complaints in PCS, they can also be a sign of additional underlying pathology. In cases of specific dizziness symptoms or limited balance recovery beyond the initial post-concussive period, a quantitative vestibular assessment may also be needed. Electronystagmography and videonystagmography (ENG/VNG), rotary chair testing (RCT), and vestibular evoked myogenic potentials (VEMPs) have all been identified as valid assessment tools for vestibular dysfunction following traumatic brain injury (TBI). The assessment of balance and dizziness following sports-related concussions is an integral piece of the puzzle for removal from play, assessment of severity, and management.

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