Ann Clin Neurophysiol.  2020 Oct;22(2):67-74. 10.14253/acn.2020.22.2.67.

Vestibular-evoked myogenic potentials: principle and clinical findings

• Choi JY

• KMID: 2511081
• DOI: http://doi.org/10.14253/acn.2020.22.2.67

Abstract

Vestibular-evoked myogenic potentials (VEMPs) are useful for evaluating the vestibulocollic reflex arising mostly from the saccule and the vestibuloocular reflex originating from the utricle. VEMPs can vary with the characteristics of the applied stimuli and the effects of aging and diseases. VEMPs have been found to be useful for diagnosing superior canal dehiscence, but their usefulness for other clinical disorders remains unclear. This review discusses the principles of VEMP tests and summarizes the findings for VEMPs in common vestibular disorders.

Keyword

Vestibular-evoked myogenic potentials; Saccule and utricle; Vestibular disorders

Figure

• 

  Fig. 1. Stimulus and neural substrates of vestibular-evoked myogenic potentials (VEMPs). AC, air-conducted; BC, bone-conducted sounds; IO, inferior oblique muscle; III, oculomotor nucleus; IV, trochlear nucleus; MLF, medial longitudinal fasciculus; VI, abducens nucleus; VNc, vestibular nucleus; U, utricle; VST, vestibulospinal tract; S, saccule; SCM, sternocleidomastoid muscle.

• 

  Fig. 2. Vestibular-evoked myogenic potential (VEMP) findings in acute vestibular neuritis (VN). VN involving both the superior and inferior divisions manifests as abnormal cervical and ocular VEMPs with caloric unresponsiveness on the affected side (left column). In contrast, superior VN causes abnormal ocular VEMPs and caloric weakness (middle column), while inferior VN only decreases cervical VEMPs (right column). L, left; R, right.

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  Fig. 3. Clinical findings of superior canal dehiscence (SCD). (A) Temporal bone computed tomography showing right-side SCD (white circles). (B) Ocular vestibular-evoked myogenic potentials (VEMPs) showing increased amplitudes during left-ear stimulation with a tone burst. (C) The cervical VEMP threshold test revealed a decreased threshold in the left ear compared with the right eye. (D) Pure-tone audiometry in the left ear demonstrated an air-bone gap with a low-frequency range in addition to enhanced bone conduction inducing a negative threshold.

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