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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2002 September;52(3):101-6
Vestibular evoked myogenic potentials analysis in equilibrium disorders
Giuliano D. A., Gallina S., Speciale R., Cupido G., Restivo S.
Clinica Otorinolaringoiatrica Base Università degli Studi di Palermo, Palermo
Background. The vestibular evoked myogenic potentials are bioelectrical potentials generated by the vestibulo-sternocleidomastoid reflex activation induced by low frequency and high intensity acoustic stimuli. The aim of the paper is to evaluate the usefulness of the analysis of these potentials in the vestibulospinal system assessment of patients with equilibrium disorders different for etiology and clinical features.
Methods. Twenty-six subjects (17 females, 9 males; mean age ±SD: 43.7±13.8; range 17-71 years) with vertigo due to different otoneurologic diseases: Ménière’s disease (35%; 9/26), cupulocanalolithiasis (31%; 8/26), vestibular neuronitis (20%; 5/26), multiple sclerosis (12%; 3/26), acoustic neuroma (2%; 1/26), were recruited. In all cases the vestibular evoked myogenic potentials recording, induced by 5 Hz frequency and 95 dB HL intensity clicks, through surface electrodes, was performed. In subjects with multiple sclerosis, Ménière’s disease or vestibular neuronitis, the recording was carried out twice, once in a subacute phase and then after the recovery.
Results. In patients with cupulocanalolithiasis or acoustic neuroma, the absence of the response or an alteration of its latencies on the pathologic side was found in 67% (6/9) of the cases. In subjects with other diseases, in subacute phase, an abnormal response in 59% (10/17) of the cases and a total absence in 12% (2/17) were present, whereas, in recovery phase, the response kept on being pathological in 18% (3/17) of the patients, absent in no cases.
Conclusions. The analysis of vestibulo-sternocleidomastoid reflex induced by acoustic stimuli proves to be a very useful method in the vestibulospinal system assessment, in order to evaluate its dysfunctions or to test its recovery. It also represents one of the few indicators of saccular macular activity.