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Vestibular evoked myogenic potentials in brainstem stroke.

Chia-Hung Chen1, Yi-Ho Young

  • 1Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei.

The Laryngoscope
|June 5, 2003
PubMed
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Vestibular evoked myogenic potential (VEMP) testing, alongside caloric testing, is crucial for diagnosing brainstem strokes. Combining these auditory vestibular tests significantly improves the detection rate of brainstem stroke in patients with acute vertigo.

Area of Science:

  • Neurology
  • Neuroscience
  • Otolaryngology

Background:

  • Vestibular evoked myogenic potential (VEMP) is widely used for posterior fossa tumors but understudied in posterior fossa stroke.
  • Brainstem stroke diagnosis can be challenging, necessitating advanced diagnostic tools.

Purpose of the Study:

  • To investigate the role and efficacy of VEMP testing in patients diagnosed with brainstem stroke.
  • To compare VEMP findings with traditional caloric testing in this patient cohort.

Main Methods:

  • A retrospective study involving seven patients with confirmed brainstem stroke (infarction or hemorrhage).
  • Patients underwent a comprehensive auditory vestibular test battery, including caloric and VEMP tests, followed by MRI.
  • Clinical manifestations and neuroimaging findings were correlated with vestibular test results.

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Main Results:

  • All patients presented with dizziness/vertigo; 71% had spontaneous nystagmus and 3 (43%) had ataxia.
  • Caloric testing showed abnormalities in 71% of ears, while VEMP testing revealed abnormalities in 79% of ears.
  • Combining caloric and VEMP testing increased the abnormal detection rate to 93% for brainstem stroke.

Conclusions:

  • VEMP testing evaluates the sacculocollic reflex (lower brainstem), complementing caloric testing's assessment of the vestibulo-ocular reflex (upper brainstem).
  • Both caloric and VEMP testing are recommended for comprehensive evaluation of brainstem stroke extent.
  • These auditory vestibular tests are valuable adjuncts to MRI in diagnosing brainstem lesions.