Vestibular evoked myogenic potentials in acoustic tumor patients with normal auditory brainstem responses

In order to clarify the utility of the vestibular evoked myogenic potential (VEMP) in detecting acoustic tumors, we report two patients who were found to have normal auditory brainstem responses (ABRs) and abnormal VEMPs. To record VEMPs, electromyographic responses to brief loud clicks (0.1 ms at 95 dBnHL) were amplified and averaged on the sternocleidomastoid muscle ipsilateral to the stimulated side. The stimulation rate was 5 Hz and the analysis time 50 ms. The first case was a 54-year-old woman in whom VEMPs were absent on the affected side while caloric tests and ABRs were normal. The second case was a 58-year-old woman whose VEMPs were absent on the affected side while caloric tests revealed a 22% canal paresis and normal ABRs. These results and previous studies suggested that the VEMP could reflect a function different from those evaluated by the ABR or the caloric test. We concluded that the VEMP can provide useful information in diagnosing acoustic tumors.