Vestibular neuritis has selective effects on air- and bone-conducted cervical and ocular vestibular evoked myogenic potentials

The aim of this paper was to evaluate prospectively, in a group of patients affected by VN, a diagnostic protocol employing C-VEMPs, O-VEMPs and vHIT together. The diagnosis of vestibular neurolabyrinthitis was based on the clinical history, absence of associated auditory or neurological symptoms, and a neuro-otological examination with an evaluation of lateral semicircular canal function using the Fitzgerald-Hallpike caloric vestibular test and ice test. Our series revealed an incidence of 55% of superior and inferior vestibular neurolabyrinthitis, 40% of superior vestibular neurolabyrinthitis and 5% of inferior vestibular neurolabyrinthitis. These data, however, comprised different degrees of vestibular involvement considering the evaluation of each single vestibular end-organ with potential different prognosis. Four patients had only deficits of the horizontal and superior semicircular canals or their ampullary nerves. The implementation of C-VEMPs, O-VEMPs and vHIT in a vestibular diagnostic protocol has made possible to observe patients with ampullary VN, unidentifiable with other types of vestibular exams. The effect of age seems to have some impact on the recovery. When recovery firstly involves the utricular and saccular nerves and subsequently the ampullary nerves, it may be reasonable to expect a more favorable and successful outcome.

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“…The clinical use of both VEMPs and vHIT has modified our knowledge in several vestibular diseases [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…One of the vestibular diseases that may benefit of a diagnostic protocol, including C-VEMPs, O-VEMPs and vHIT together, is represented by vestibular neuritis (VN) [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vestibular neuritis

Magliulo

Iannella

Gagliardi

et al. 2014

Eur Arch Otorhinolaryngol

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“…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.…”

Section: Vestibular Neuritismentioning

confidence: 79%

“…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.…”

Section: What Are Ovemps?mentioning

confidence: 99%

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

Weber

Rosengren

2015

Curr Neurol Neurosci Rep

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“…with Mé-nière disease (MD), vestibular neuritis, otosclerosis, superior canal dehiscence syndrome, vestibular schwannoma, etc. [Rauch et al, 2004;Govender et al, 2011;Young, 2013;Zuniga et al, 2013;Lin et al, 2014]. The cVEMP test assesses the saccular function via the ipsilateral sacculocollic reflex, while the oVEMP test primarily evaluates the utricular function and the crossed vestibulo-ocular reflex [Curthoys, 2010].…”

Section: Introductionmentioning

confidence: 99%

Role of the Frontal Sinus in Mediating Ocular Vestibular-Evoked Myogenic Potentials by Bone Vibration Stimuli Applied to the Forehead

et al. 2017

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This study investigated ocular vestibular-evoked myogenic potential (oVEMP) tests via Fpz and Fz taps to assess the role of the frontal sinus in mediating oVEMP elicitation. Forty healthy subjects and 80 patients with Ménière disease (MD) underwent a series of oVEMP tests via a minishaker tapping at the Fpz and Fz sites in a randomized order. Response rates of oVEMP test via various tapping sites were compared. Dimensions of the frontal sinus were measured via CT scan. A significantly negative correlation between the age and height of the frontal sinus was noted, and the cutoff age for discriminating present and absent Fpz oVEMPs in MD patients was 52 years. Additionally, oVEMPs by Fpz tapping were more efficiently presented in males than females, likely because of the greater resonance by the larger height of the frontal sinus in males (3.88 ± 0.68 cm) than females (3.42 ± 0.67 cm). In conclusion, the height of the frontal sinus plays a role in mediating the elicitation of oVEMPs. The oVEMPs could be easily elicited by the first-order bone vibration (Fpz/Fz tapping) coupled with the second-order resonance effect (with a high extent of the frontal sinus). Thus, initial tapping at the Fpz site is suggested. If it fails, try the Fz site for screening the oVEMPs.

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Vestibular neuritis has selective effects on air- and bone-conducted cervical and ocular vestibular evoked myogenic potentials

Cited by 57 publications

References 38 publications

A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vestibular neuritis

A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vestibular neuritis

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

Role of the Frontal Sinus in Mediating Ocular Vestibular-Evoked Myogenic Potentials by Bone Vibration Stimuli Applied to the Forehead

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