Ann Rehabil Med.  2014 Apr;38(2):226-233.

Difference of Diagnostic Rates and Analytical Methods in the Test Positions of Vestibular Evoked Myogenic Potentials

• Kim JH
• Park JM
• Yong SY
• Kim JH
• Kim H
• Park SY

Abstract

OBJECTIVE
To compare the differences of diagnostic rates, of the two widely used test positions, in measuring vestibular evoked myogenic potentials (VEMP) and selecting the most appropriate analytical method for diagnostic criteria for the patients with vertigo.
METHODS
Thirty-two patients with vertigo were tested in two comparative testing positions: turning the head to the opposite side of the evaluating side and bowing while in seated position, and bowing while in supine positions. Abnormalities were determined by prolonged latency of p13 or n23, shortening of the interpeak latency, and absence of VEMP formation.
RESULTS
Using the three criteria above for determining abnormalities, both the seated and supine positions showed no significant differences in diagnostic rates, however, the concordance correlation of the two positions was low. When using only the prolonged latency of p13 or n23 in the two positions, diagnostic rates were not significantly different and their concordance correlation was high. On the other hand, using only the shortened interpeak latency in both positions showed no significant difference of diagnostic rates, and the degree of agreement between two positions was low.
CONCLUSION
Bowing while in seated position with the head turned in the opposite direction to the area being evaluated is found to be the best VEMP test position due to the consistent level of sternocleidomastoid muscle tension and the high level of compliance. Also, among other diagnostic analysis methods, using prolonged latency of p13 or n23 as the criterion is found to be the most appropriate method of analysis for the VEMP test.

Keyword

Vestibular evoked myogenic potentials (VEMP); Patient positioning; Data interpretation

MeSH Terms

Compliance
Hand
Head
Humans
Muscle Tonus
Patient Positioning
Supine Position
Vertigo
Vestibular Evoked Myogenic Potentials*

Figure

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  Fig. 1 Testing position. (A) Lowering one's head toward the opposite side of the testing side in seated (position 1: a, anterial; b, lateral). (B) Lifting one's head 10 cm to the opposite side of the testing side in supine (position 2: a, anterial; b, lateral).

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  Fig. 2 Typical response and measurement parameters of vestibular evoked myogenic potentials. IPL, interpeak latency.

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  Fig. 3 An example of absence of vestibular evoked myogenic potentials formation.

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  Fig. 4 In the case of defining as a disorder when any of the three diagnosis criteria (prolonged latency, shortened interpeak latency, and absence of vestibular evoked myogenic potentials formation) shows abnormality: diagnosis rates of both positions showed no significant differences in both sides but concordance correlation was low.

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  Fig. 5 In the case of defining disorder solely by prolonged latency: diagnosis rates of both positions showed no significant differences in both sides and concordance correlation was high.

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  Fig. 6 In the case of defining disorder by shortened interpeak latency alone: diagnosis rates of both positions showed no significant differences in both sides but concordance correlation was low.

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