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Neurology. 2017 Nov 28;89(22):2288-2296. doi: 10.1212/WNL.0000000000004690. Epub 2017 Nov 1.

Practice guideline: Cervical and ocular vestibular evoked myogenic potential testing: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

Author information

1
From the Department of Neurology (T.D.F.), Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix; Department of Neurology (J.G.C.), Prince of Wales Hospital, Clinical School, University of New South Wales and Neuroscience Research Australia, Randwick, Sydney; Departments of Neurology (K.A.K., B.C.) and Neurosurgery (J.F.), University of Michigan, Ann Arbor; Department of Audiology and Neurotology (K.B.), Karolinska University Hospital, Stockholm, Sweden; Department of Neurology and German Center for Dizziness and Balance Disorders (M.S.), University of Munich, Germany; Department of Neurology (H.L.), Keimyung University School of Medicine, Daegu, South Korea; Department of Neurology (M.F.W.), Case Western Reserve University, and Louis Stokes Cleveland Veterans Affairs Medical Center, OH; Bronson Neuroscience Center (E.A.), Kalamazoo, MI; and Department of Neurology (D.S.G.), Charleston Area Medical Center, WV.

Abstract

OBJECTIVE:

To systematically review the evidence and make recommendations with regard to diagnostic utility of cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP, respectively). Four questions were asked: Does cVEMP accurately identify superior canal dehiscence syndrome (SCDS)? Does oVEMP accurately identify SCDS? For suspected vestibular symptoms, does cVEMP/oVEMP accurately identify vestibular dysfunction related to the saccule/utricle? For vestibular symptoms, does cVEMP/oVEMP accurately and substantively aid diagnosis of any specific vestibular disorder besides SCDS?

METHODS:

The guideline panel identified and classified relevant published studies (January 1980-December 2016) according to the 2004 American Academy of Neurology process.

RESULTS AND RECOMMENDATIONS:

Level C positive: Clinicians may use cVEMP stimulus threshold values to distinguish SCDS from controls (2 Class III studies) (sensitivity 86%-91%, specificity 90%-96%). Corrected cVEMP amplitude may be used to distinguish SCDS from controls (2 Class III studies) (sensitivity 100%, specificity 93%). Clinicians may use oVEMP amplitude to distinguish SCDS from normal controls (3 Class III studies) (sensitivity 77%-100%, specificity 98%-100%). oVEMP threshold may be used to aid in distinguishing SCDS from controls (3 Class III studies) (sensitivity 70%-100%, specificity 77%-100%). Level U: Evidence is insufficient to determine whether cVEMP and oVEMP can accurately identify vestibular function specifically related to the saccule/utricle, or whether cVEMP or oVEMP is useful in diagnosing vestibular neuritis or Ménière disease. Level C negative: It has not been demonstrated that cVEMP substantively aids in diagnosing benign paroxysmal positional vertigo, or that cVEMP or oVEMP aids in diagnosing/managing vestibular migraine.

PMID:
29093067
PMCID:
PMC5705249
DOI:
10.1212/WNL.0000000000004690
[Indexed for MEDLINE]
Free PMC Article

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