The ocular vestibular-evoked myogenic potential to air-conducted sound; probable superior vestibular nerve origin

Dizziness and Imbalance in the Elderly: Age-related Decline in the Vestibular System

“…Vestibular evoked myogenic potentials (VEMPs) are short-latency muscle responses typically recorded from the neck muscles (cVEMPs) or from the eye muscles (oVEMPs) [46][47][48]. Clinical and physiological studies have shown that cVEMPs reflect the function of the saccule and the inferior vestibular nerve whereas oVEMPs reflects the function of the utricle and the superior vestibular nerve [49][50][51][52]. A cross sectional study of consecutive patients ranging from 7 to 91 years old showed an age-dependent decrease in cVEMP amplitude and an increase in cVEMP latency [53].…”

Clinical Utility of Ocular Vestibular-Evoked Myogenic Potentials (oVEMPs)

“…oVEMPs are usually abnormal in VN, regardless of whether AC or BC stimuli are used [13,14,51,16,52,15,53]. The oVEMP abnormalities are most often associated with deficits in superior nerve horizontal and anterior canal fibres, and so these studies provide evidence that oVEMPs are probably mediated by superior nerve otolith fibres (which are mainly utricular), at least for the stimuli that have been tested thus far.…”

“…First, evidence from animal studies suggests that otolith afferents are preferentially activated by sound and vibration [11,12]. Second, patients with vestibular neuritis that appears to selectively affect the superior vestibular nerve typically have absent oVEMPs, suggesting that the reflex depends upon this nerve portion [13][14][15][16]. The superior vestibular nerve contains all utricular afferents, but only a small portion of saccular afferents.…”

Neuritis des N. vestibularis inferior

“…B. 100-dB-nHL-Burst-oder -Clickreizung) über Luft-oder Knochenleitungsreize können Sakkulus und Utrikulus stimuliert und auf der Basis dieser vestibulären Reflexe typische biphasische Potenziale (VEMP) mittels Oberflächen-elektromyographie abgeleitet werden [2,9].…”

“…Andererseits wird der utrikulookuläre Reflex geprüft, der vom Utrikulus über den N. vestibularis superior zu den extraokulären Augenmuskeln zieht und einen Hinweis für den überwiegenden Anteil der Utrikulusfunktion darstellt (oVEMP; [2]). Die Besonderheit dieses Reflexes besteht darin, dass die Reflexstrecken zentral jeweils nach kontralateral kreuzen [9].…”