International Journal of Otorhinolaryngology and Head and Neck Surgery | November 2021 | Vol 7 | Issue 11 Page 1724
International Journal of Otorhinolaryngology and Head and Neck Surgery
Sirige S et al. Int J Otorhinolaryngol Head Neck Surg. 2021 Nov;7(11):1724-1728
http://www.ijorl.com
pISSN 2454-5929 | eISSN 2454-5937
Original Research Article
Usefulness of vestibular evoked myogenic potentials in diagnosis of
peripheral vestibular disorders
Sreelatha Sirige, S. Rajesh Kumar*, V. Krishna Chaitanya, Vasu Kumar Reddy
INTRODUCTION
Vestibular evoked myogenic potentials (VEMP) are
electromyographic responses to high-intensity acoustic
stimuli that are used as a test for the vestibular system by
providing information on otolith function and the
functional integrity of the inferior vestibular nerve.
1
VEMP are a test that evaluates the saccule and inferior
vestibular nerve in the peripheral vestibular nervous
system. These are easy to perform, non-invasive, and
cause minimal patient discomfort.
2
BPPV, Meniere’s disease, and Vestibular Neuritis are the
most common diseases that cause peripheral vertigo.
3
The
development of peripheral vertigo can be associated with
the saccule or inferior vestibular nerve, which are
pathways for VEMP. Also, in Meniere’s disease, as the
process may be associated with a pathologic change in
the saccule, VEMP testing could provide information
about the involvement of the saccule in peripheral
vertigo. Patients with vestibular neuritis show unilateral
peripheral vestibular dysfunction mainly in the superior
vestibular nerve.
4
ABSTRACT
Background: Vestibular evoked myogenic potentials (VEMP) are electromyographic responses to high-intensity
acoustic stimuli to test vestibular system, otolith function and integrity of inferior vestibular nerve. These are easy to
perform and non-invasive. In this study, we aimed at clinical application of VEMP to evaluate common peripheral
vestibular disorders.
Methods: Prospective observational study carried in ENT department during January 2015-November 2016 over 40
patients in age group between 30-70 years with history of vertigo who underwent regular neuro-otological
examination and VEMP.
Results: Of these, 25 diagnosed with BPPV, 11 with Meniere’s disease, and four with vestibular neuritis. Eight
patients showed delayed VEMP responses. 28 (70%) patients had normal VEMP, 12 (30%) had abnormal VEMP
responses. Out of 25 patients suffering from benign paroxysmal positional vertigo (BPPV) posterior semi-circular
canal was involved in 20 (80%) patients and lateral semi-circular canal in 5 (20%) patients. Abnormal VEMP was
found in 5 (20%) patients involving posterior semi-circular canal and in 1 (20%) patient involving lateral semi-
circular canal. In patients with Meniere’s disease stage I, Meniere’s disease was observed in 7 (63.6%), stage II in 2
(18.1%), and stage IV disease in 1 (9.09%) patient. In these patients, abnormal VEMP was found in 3 (42.8%) of 7
stage I, 1 (50%) of 2 stage II and 1 (100%) of stage IV patients. One (20%) patient had abnormal VEMP responses
during study.
Conclusions: VEMP are short-latency EMG that evaluates saccule and inferior vestibular nerve in peripheral
vestibular nervous system. VEMP should be considered as complementary test along with conventional vestibular
function tests in patients with peripheral vertigo.
Keywords: VEMP, Vestibular disorders, Vertigo, Meniere’s disease, Vestibular neuritis
Department of ENT, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
Received: 04 October 2021
Revised: 19 October 2021
Accepted: 20 October 2021
*Correspondence:
Dr. S. Rajesh Kumar,
E-mail: entdrrajesh@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/issn.2454-5929.ijohns20214220