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Ann Otol Rhinol Laryngol. 2015 Jun;124(6):458-65. doi: 10.1177/0003489414564997. Epub 2014 Dec 21.

Clinical characteristics of patients with abnormal ocular/cervical vestibular evoked myogenic potentials in the presence of normal caloric responses.

Author information

1
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan iwashin-tky@umin.ac.jp.
2
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.

Abstract

OBJECTIVE:

To investigate the clinical features and vestibular symptoms of patients with abnormal ocular vestibular evoked myogenic potentials (oVEMPs) and/or cervical VEMPs (cVEMPs) in the presence of normal caloric responses.

STUDY DESIGN:

Retrospective chart review.

SETTING:

Tertiary referral center.

METHODS:

One thousand five hundred twenty-one consecutive patients with balance problems who underwent the caloric, cVEMP, and oVEMP tests were included, and patients who showed abnormal oVEMPs and/or cVEMPs in the presence of normal caloric responses were selected. Clinical characteristics, diagnoses, and vestibular symptoms of the patients were analyzed.

RESULTS:

Of the 1521 patients, 227 (15%) were found to have abnormal oVEMPs and/or cVEMP responses with normal caloric responses. Benign paroxysmal positional vertigo (BBPV), Meniere's disease, and vestibular migraine were the common diagnoses of these patients. Eighty-one patients (36%) could not be diagnosed with a recognizable disease. Multiple episodes of spinning vertigo with a duration of seconds to hours were their most common vestibular symptoms.

CONCLUSION:

BPPV, Meniere's disease, and vestibular migraine are the most frequent diagnoses showing abnormal oVEMP and/or cVEMPs without canal paresis. Apart from these clinical entities, a portion of undiagnosed patients with multiple episodes of vertigo might have a disease that involves the otolith organs only.

KEYWORDS:

otolith; saccule; utricle; vestibular; vestibular evoked myogenic potential

PMID:
25533509
DOI:
10.1177/0003489414564997
[Indexed for MEDLINE]

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