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Brainstem lesion in benign paroxysmal vertigo children: Evaluated by a combined ocular and cervical vestibular-evoked

Kuei-You Lin1, Ying-Shuo Hsu, Yi-Ho Young

  • 1Department of Otolaryngology, National Taiwan University Hospital, 1 Chang-te Street, Taipei, Taiwan.

International Journal of Pediatric Otorhinolaryngology
|March 9, 2010
PubMed

Insights

Children with benign paroxysmal vertigo (BPV) show normal upper brainstem function but impaired lower brainstem pathways. This study used combined ocular and cervical vestibular-evoked myogenic potential tests to identify the affected brainstem region in pediatric BPV.

Area of Science:

  • Pediatric Neurology
  • Vestibular System Disorders
  • Neurophysiology

Background:

  • Benign paroxysmal vertigo (BPV) is a common cause of vertigo in children.
  • The specific brainstem pathways affected in pediatric BPV remain incompletely understood.

Purpose of the Study:

  • To investigate whether the upper or lower brainstem is more frequently affected in children with BPV.
  • To differentiate brainstem involvement using combined ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) tests.

Main Methods:

  • Fifteen children diagnosed with BPV (ages 4-14) and 15 age-matched healthy controls were enrolled.
  • All participants underwent pure tone audiometry, stabilometry, and combined oVEMP and cVEMP testing with acoustic stimulation.

Main Results:

  • BPV patients exhibited normal hearing and oVEMPs, indicating intact upper brainstem vestibulo-ocular reflex pathways.
  • Delayed cVEMPs were observed in 73% of BPV patients, significantly differing from healthy controls (100% normal cVEMPs).
  • Stabilometry showed significant differences in sway between BPV patients and controls, but these did not correlate with cVEMP results.

Conclusions:

  • Normal oVEMPs suggest the upper brainstem vestibulo-ocular reflex pathway is preserved in pediatric BPV.
  • Delayed cVEMPs indicate a lesion in the lower brainstem along the sacculo-collic reflex pathway.
  • The findings suggest the lower brainstem is more frequently impacted than the upper brainstem in children with BPV.
Abstract

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