Journal
OTOLOGY & NEUROTOLOGY
Volume 44, Issue 6, Pages E419-E427Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAO.0000000000003909
Keywords
Acute vestibular neuritis; Subjective visual horizontal; Vestibular evoked myogenic potentials
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This study found a significant correlation between the subjective visual horizontal (SVH) and ocular-VEMPs (oVEMPs) in patients with acute vestibular neuritis, suggesting that both tests can assess otolith function.
ObjectVestibular evoked myogenic potentials (VEMPs) and the subjective visual horizontal (SVH) (or vertical [SVV]) have both been considered tests of otolith function: ocular-VEMPs (oVEMPs) utricular function, cervical VEMPs (cVEMPs) saccular function. Some studies have reported association between decreased oVEMPs and SVH, whereas others have not.DesignA retrospective study of test results.SettingA tertiary, neuro-otology clinic, Royal Prince Alfred Hospital, Sydney, Australia.MethodWe analyzed results in 130 patients with acute vestibular neuritis tested within 5 days of onset. We sought correlations between the SVH, oVEMPs, and cVEMPs to air-conducted (AC) and bone-conducted (BC) stimulation.ResultsThe SVH deviated to the side of lesion, in 123 of the 130 AVN patients, by 2.5 to 26.7 degrees. Ninety of the AVN patients (70%) had abnormal oVEMPs to AC, BC or both stimuli, on the AVN side (mean asymmetry ratio +/- SD [SE]): (64 +/- 45.0% [3.9]). Forty-three of the patients (35%) had impaired cVEMPs to AC, BC or both stimuli, on the AVN side, [22 +/- 41.6% (4.1)]. The 90 patients with abnormal oVEMP values also had abnormal SVH. Correlations revealed a significant relationship between SVH offset and oVEMP asymmetry (r = 0.80, p < 0.001) and a weaker relationship between SVH offset and cVEMP asymmetry (r = 0.56, p < 0.001).ConclusionsThese results indicate that after an acute unilateral vestibular lesion, before there has been a chance for vestibular compensation to occur, there is a significant correlation between the SVH, and oVEMP results. The relationship between SVH offset and oVEMP amplitude suggests that both tests measure utricular function.
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