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Development of ocular vestibular-evoked myogenic potentials in small children
Shou-Jen Wang1, Wu-Shiun Hsieh, Yi-Ho Young
1Department of Otolaryngology, Catholic Cardinal Tien Hospital, Fu Jen Catholic University School of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Insights
The otolithic-ocular reflex, measured by ocular vestibular-evoked myogenic potential (oVEMP) tests, is not present in newborns but develops by age two. This maturation is crucial for balance and independent gait in young children.
Area of Science:
- Vestibular system development
- Ocular motor control
- Pediatric audiology
Background:
- The otolithic-ocular reflex (oVEMP) plays a role in maintaining visual stability during head movements.
- Understanding the developmental trajectory of the oVEMP is essential for assessing vestibular function in infants and young children.
Purpose of the Study:
- To investigate the development of the otolithic-ocular reflex in children younger than three years using the ocular vestibular-evoked myogenic potential (oVEMP) test.
- To establish normative oVEMP responses in different pediatric age groups.
Main Methods:
- A prospective study involving three groups: newborns (n=20), children aged 1-3 years (n=15), and children aged 4-13 years (n=15).
- All participants underwent hearing assessments (auditory brainstem response or audiometry) and the oVEMP test.
Main Results:
- Typical biphasic oVEMP waveforms were absent in newborns but present in 40% of children aged 1-3 years and 100% of children aged 4-13 years.
- In the 1-3 year group, children over 25 months showed clear oVEMPs with latencies and amplitudes similar to older children, indicating reflex maturation.
- All subjects had normal hearing, ruling out auditory impairment as a factor.
Conclusions:
- The otolithic-ocular reflex (oVEMP) is immature at birth and typically develops after two years of age.
- Maturation of the oVEMP is linked to the development of independent gait and improved balance control in young children.
- oVEMP testing can be a valuable tool for assessing vestibular function in pediatric populations.
Objectives/Hypothesis:
This study investigated the development of otolithic-ocular reflex in small children (<3 years old) via the ocular vestibular-evoked myogenic potential (oVEMP) test.
Study Design:
Prospective study.
Methods:
Twenty full-term newborns (group A), 15 children aged 1 to 3 years (group B), and 15 children aged 4 to 13 years (group C) were enrolled in this study. All children underwent auditory brainstem response testing or audiometry, and the oVEMP test.
Results:
All subjects had normal hearing. Typical biphasic oVEMP waveforms were not observed in the 20 newborns, but were present in six (40%) of 15 children aged 1 to 3 years and all (100%) children aged 4 to 13 years, exhibiting a significant difference. In group B, except for the nine children aged 12 to 24 months, the remaining six children, aged 25 to 47 months, had clear oVEMPs, with the mean nI latency and nI-pI amplitude resembling those in children aged 4 to 13 years, indicating that the otolithic-ocular reflex is mature in children aged >2 years.
Conclusions:
Despite the well-developed caloric and cervical VEMP responses in early life, oVEMPs are not present in newborns, but are present in children aged >2 years who can walk with a gait resembling an adult. Maturation of the otolithic-ocular reflex is important to balance control, which is necessary in small children for independent gait.
