Difference of Diagnostic Rates and Analytical Methods in the Test Positions of Vestibular Evoked Myogenic Potentials

다국어 초록 (Multilingual Abstract)

Objective To compare the differences of diagnostic rates, of the two widely used test positions, in measuring vestibular evoked myogenic potentials (VEMP) and selecting the most appropriate analytical method for diagnostic criteria for the patients with vertigo.Methods Thirty-two patients with vertigo were tested in two comparative testing positions: turning the head to the opposite side of the evaluating side and bowing while in seated position, and bowing while in supine positions. Abnormalities were determined by prolonged latency of p13 or n23, shortening of the interpeak latency, and absence of VEMP formation.Results Using the three criteria above for determining abnormalities, both the seated and supine positions showed no significant differences in diagnostic rates, however, the concordance correlation of the two positions was low. When using only the prolonged latency of p13 or n23 in the two positions, diagnostic rates were not significantly different and their concordance correlation was high. On the other hand, using only the shortened interpeak latency in both positions showed no significant difference of diagnostic rates, and the degree of agreement between two positions was low.Conclusion Bowing while in seated position with the head turned in the opposite direction to the area being evaluated is found to be the best VEMP test position due to the consistent level of sternocleidomastoid muscle tension and the high level of compliance. Also, among other diagnostic analysis methods, using prolonged latency of p13 or n23 as the criterion is found to be the most appropriate method of analysis for the VEMP test.

참고문헌 (Reference)

1 김훈, "현훈증 환자 평가에서 전정유발근전위의 임상적 유용성" 대한이비인후과학회 46 (46): 391-395, 2003

2 Colebatch JG, "Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation" 42 : 1635-1636, 1992

3 Mudduwa R, "Vestibular evoked myogenic potentials: review" 124 : 1043-1050, 2010

4 Murofushi T, "Vestibular evoked myogenic potentials in patients with acoustic neuromas" 124 : 509-512, 1998

5 Patko T, "Vestibular evoked myogenic potentials in patients suffering from an unilateral acoustic neuroma: a study of 170 patients" 114 : 1344-1350, 2003

6 Ferber-Viart C, "Vestibular evoked myogenic potentials in humans: a review" 119 : 6-15, 1999

7 Matsuzaki M, "Vestibular evoked myogenic potentials in acoustic tumor patients with normal auditory brainstem responses" 256 : 1-4, 1999

8 Goh EK, "Vestibular evoked myogenic potential" 19 : 13-17, 2008

9 Kim JD, "The effects of test positions and acoustic stimulations on the vestibular evoked myogenic potentials" 6 : 21-28, 2007

10 Park SH, "The clinical significance of vestibular evoked myogenic potential evoked by click sound" 44 : 1253-1258, 2001

11 Murofushi T, "Physiological and anatomical study of click-sensitive primary vestibular afferents in the guinea pig" 117 : 66-72, 1997

12 Bickford RG, "Nature of average evoked potentials to sound and other stimuli in man" 112 : 204-223, 1964

13 Ferber-Viart C, "Myogenic vestibular-evoked potentials in normal subjects:a comparison between responses obtained from sternomastoid and trapezius muscles" 117 : 472-481, 1997

14 Colebatch JG, "Myogenic potentials generated by a click-evoked vestibulocollic reflex" 57 : 190-197, 1994

15 Ahn YJ, "Diagnostic value of vestibular evoked myogenic potential in acoustic neuroma" 6 : 138-142, 2007

16 Tullio P, "Das ohr und die entstehung der sprache und schrift" Urban & Schwarzenberg 1929

17 Wang CT, "Comparison of the head elevation versus rotation methods in eliciting vestibular evoked myogenic potentials" 27 : 376-381, 2006

18 Cody DT, "Averaged evoked myogenic responses in normal man" 79 : 400-416, 1969

19 Lee SK, "Age-related differences in parameters of vestibular evoked myogenic potentials" 128 : 66-72, 2008

20 Didier A, "Acoustic responses recorded from the saccular bundle on the eighth nerve of the guinea pig" 37 : 123-127, 1989

21 Murofushi T, "Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis: an indicator of inferior vestibular nerve involvement?" 122 : 845-848, 1996