J Korean Neurol Assoc.  2007 Feb;25(1):50-56.

Vestibular Evoked Myogenic Potential in Meniere's Syndrome

Affiliations
  • 1Department of Neurology, Gil Medical Center, Gachon University of Medicine and Science, Korea.
  • 2Department of Neurology, Seoul National University College of Medicine, Korea. jisookim@snu.ac.kr
  • 3Department of Otolaryngology, Seoul National University College of Medicine, Korea.

Abstract

BACKGROUND: Acoustic stimulation of the saccule can evoke the vestibulocolic reflex and the inhibitory potential can be measured in the ipsilateral sternocleidomastoideus as a vestibular evoked myogenic potential (VEMP). We investigated the saccular dysfunction in patients with Meniere's syndrome by using VEMP, and correlated the findings with those of other vestibular function tests.
METHODS
Thirty-six patients, 29 with Meniere's disease and 7 with delayed endolymphatic hydrops, underwent interictal VEMP. Eight patients reported Tumarkins otolithic crisis. The patients also had a bithermal caloric test, testing of the subjective visual vertical (SVV), and brainstem auditory evoked potentials (BAEP) in addition to pure tone and speech audiometry.
RESULTS
Abnormal VEMP was observed in 21 (58.3%) patients. All the patients with abnormal VEMP showed decreased amplitude or absence of VEMP in the lesion side. Three of them also exhibited delayed p13 or n23 latency. The VEMP was abnormal in four of the 13 patients with normal calorics, 13 of the 21 with normal SVV, and 11 of the 21 with normal BAEP. The abnormal VEMP was more common in patients with delayed endolymphatic hydrops (71.4%) and Tumarkins otolithic crisis (75.0%), but without statistical significance.
CONCLUSIONS
VEMP detects saccular dysfunction in Meniere's syndrome. The abnormal VEMP in some patients with normal calorics, SVV or BAEP suggests differential involvement of the vestibular subsystem in Menieres syndrome especially in the early stage.

Keyword

Vestibular evoked myogenic potential; Meniere's disease; Delayed endolymphatic hydrops; Tumarkin's otolithic crisis

MeSH Terms

Acoustic Stimulation
Audiometry, Speech
Caloric Tests
Endolymphatic Hydrops
Evoked Potentials, Auditory, Brain Stem
Humans
Meniere Disease*
Otolithic Membrane
Reflex
Saccule and Utricle
Vestibular Function Tests
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