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World J Otorhinolaryngol. May 28, 2014; 4(2): 6-11
Published online May 28, 2014. doi: 10.5319/wjo.v4.i2.6
Vestibular evoked myogenic potential
Toshihisa Murofushi
Toshihisa Murofushi, Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Kawasaki 213-8507, Japan
Author contributions: Murofushi T contributed to the manuscript.
Correspondence to: Toshihisa Murofushi, Professor, Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki 213-8507, Japan.
Telephone: +81-44-8443333 Fax: +81-44-8443333
Received: January 4, 2014
Revised: January 25, 2014
Accepted: April 17, 2014
Published online: May 28, 2014

Vestibular evoked myogenic potential (VEMP), is an electromyographic response of vestibular origin evoked by sound, vibration or electrical stimulation. VEMP is widely used as a clinical test of the otolith organs. Nowadays, two kinds of VEMP, cervical VEMP (cVEMP) and ocular VEMP (oVEMP) are clinically used. cVEMP is a test of sacculo-collic reflex while oVEMP is a test of utriculo-ocular reflex. Absence of responses, large interaural asymmetry of amplitudes, prolonged peak latencies, and abnormal thresholds of responses are regarded as abnormal responses. Clinical application to various diseases of the vestibular system was performed. Using VEMP, a new type of vestibular neuritis, inferior vestibular neuritis was established. A prominent feature of VEMP in Meniere’s disease is a shift of a preferred frequency in cVEMP. The whole aspects of VEMP findings in patients with benign paroxysmal positional vertigo are not clarified yet. Sensitivity of cVEMP to vestibular schwannoma was 80.0%, while specificity was 52.7%. Concerning diagnosis of superior canal dehiscence syndrome (SCDS), oVEMP to air-conducted sound is the most helpful. Augmentation of oVEMP responses is a prominent feature in SCDS. I also presented “idiopathic otolithic vertigo”, which I proposed as a new clinical entity based on VEMP findings. Some patients complained of lateral tilting sensation in the roll plane, or tilting or translational sensation in the pitch plane without rotatory vertigo. Majority of patients with these symptoms had absent or decreased responses of oVEMP and/or cVEMP. I proposed that these patients could be diagnosed as having “idiopathic otolithic vertigo”.

Keywords: Vestibular evoked myogenic potential, Otolith, Saccule, Utricle, Otolithic vertigo

Core tip: This is a review of Vestibular evoked myogenic potential (VEMP). In this review I presented fundamentals concerning VEMP. Also I showed various types of clinical application of VEMP. Finally I introduced a new clinical entity, idiopathic otolithic vertigo which I poroposed. Idiopathic otolithic vertigo cannot be diagnosed without application of VEMP.