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Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential
T Murofushi1, K Shimizu, H Takegoshi
1Department of Otolaryngology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Tokyo 113-8655, Japan. toshi-tky@umin.ac.jp
Background:
As a parameter for the evaluation of the vestibular evoked myogenic potential (VEMP), amplitude has been used clinically. However, the significance of latency has not been considered.
Objective:
To clarify the diagnostic value of latencies of the VEMP.
Design:
We reviewed records of the VEMP of patients with various diseases and compared them with records of healthy volunteers.
Setting:
Data were collected from patients in an outpatient clinic of a tertiary care center and healthy volunteers.
Subjects:
Clinical records of 134 patients (61 men and 73 women, aged 20-75 years) were reviewed. Diagnoses were Meniere disease in 43 patients, acoustic neuroma in 62 patients, vestibular neuritis in 23 patients, and multiple sclerosis in 6 patients. Also, 18 healthy volunteers (13 men and 5 women, aged 25-38 years) were enrolled.
Intervention:
Diagnostic.
Main Outcome Measures:
Click-evoked myogenic potentials were recorded with surface electrodes over each sternocleidomastoid muscle. Latencies and amplitudes of responses were measured.
Results:
Vestibular evoked myogenic potentials were absent or decreased in 51% of patients with Meniere disease (n = 22), 39% with vestibular neuritis (n = 9), 77% with acoustic neuroma (n = 48), and 25% with multiple sclerosis (3 of 12 sides of 6 patients). Concerning latency, patients with Meniere disease or vestibular neuritis hardly showed any latency prolongation. Four patients with acoustic neuroma showed prolonged p13; all had large tumors. All patients with multiple sclerosis showed prolonged p13.
Conclusion:
Prolonged latencies of the VEMP suggest lesions in the retrolabyrinthine, especially in the vestibulospinal tract.