Furosemide Loading Vestibular Evoked Myogenic Potential for Unilateral Ménière's Disease

Abstract

The F-VEMP test may be useful in the diagnosis of endolymphatic hydrops.

Dos potenciais evocados miogênicos vestibulares nas orelhas comprometida e assintomática na Doença de Ménière unilateral

“…As to responses to sternocleidomastoid muscle in ipsilateral monoaural stimulation, we confirmed that the mean of asymmetry rate of patients that presented bilateral responses was 26 8 . In our study, we found one patient (5%) with increase in Vestibular evoked myogenic potentials that presented rate of amplitude asymmetry of 48.2%, suggesting hypersensitivity of saccular macula caused by hydrops of the organ.…”

“…Electrocochleography is not appropriate for the assessment of otolithic organs (sacculus, utriculus and semicircular canals) or descending neural pathways. The determination of saccular hydrops may be useful in the diagnosis of Ménière's disease [4][5][6][7][8] . Vestibular evoked myogenic potentials is a test used to assess sacculocollic reflex in humans, triggered by intensive sound stimulation of saccular macula, which is sensitive to sound even with total destruction of the cochlea 20 .…”

“…Absence of response to Vestibular evoked myogenic potentials in cases of Ménière's disease suggests saccular hydrops 8,10,12 . Depending on the severity of hydrops, some patients may present irreversible degeneration of sensorial epithelium of saccular macula 5,6,8,13 . Absence of response on the non-affected ear was found in 20% of our cases.…”

“…Saccular hydrops may occur in 50% of the cases of Ménière's syndrome 3 . The definition of saccular hydrops may represent an important breakthrough in the diagnosis of Ménière's disease [4][5][6][7][8] . One hundred and fifty years later, many aspects concerning etiopathogenesis and therapy of Ménière's disease are still controversial.…”

Vestibular-evoked myogenic potentials eliciting: an overview

“…In Meniere's disease, the cVEMP is absent in 55% of aVected ears and its absence correlates with low-frequency hearing loss [65].The cVEMP can be augmented in early MD [66], perhaps because the hydropic sacculus presses against the stapes footplate, enhancing saccular sensitivity to loud sound. As the disease advances, cVEMP tends to disappear [67], but can reappear or become enlarged with glycerol or frusemide, drugs which might reduce endolymphatic hydrops [68,69].…”