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A possible case of saccular endolymphatic hydrops.
1Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Japan. tseo@hyo-med.ac.jp
Summary
Vestibular-evoked myogenic potential (VEMP) testing revealed saccular hydrops in a patient with dysequilibrium. Furosemide improved VEMP responses, suggesting endolymphatic hydrops affecting the saccule.
Area of Science:
- Neuroscience
- Otolaryngology
- Audiology
Background:
- Vestibular-evoked myogenic potential (VEMP) is a key test for saccular function.
- Saccular disorders can cause significant dysequilibrium.
- Conventional vestibular tests may not always identify saccular dysfunction.
Observation:
- A 27-year-old female presented with recurrent, severe dysequilibrium and vertigo.
- Initial vestibular tests were inconclusive.
- Electrocochleography showed dominant negative summating potential (SP) bilaterally; furosemide tests were negative.
Findings:
- VEMP testing revealed reduced amplitude in the right ear, which normalized after furosemide administration.
- Furosemide also increased VEMP amplitude in the left ear.
- These results suggest bilateral endolymphatic hydrops, particularly affecting the right saccule.
Implications:
- VEMP testing can detect saccular hydrops, even when other tests are normal.
- This case highlights a potential diagnostic pathway for non-Ménière vertigo.
- Findings suggest VEMP may be valuable in diagnosing saccular dysfunction.