Air Conducted Cervical and Ocular Vestibular Evoked Myogenic Potentials in Peudotumor Cerebri Patients
DOI:
https://doi.org/10.12970/2311-1917.2014.02.03.1Keywords:
Vestibular evoked myogenic potentials, pseudotumor cerebri, idiopathic intracranial hypertension, oVEMPs, cVEMPs, vertigo, dizziness.Abstract
Objective: Pseudotumor cerebri is a disorder of unknown etiology that results in raised intracranial pressure (ICP) and characterized by attendant signs and symptoms of increased ICP in an alert and oriented patient but without localizing neurologic findings. Vestibular evoked myogenic potentials (VEMPs) are short latency reflex responses produced by stimulation of the vestibular apparatus. The purpose of this study was to determine whether group of pseudotumor cerebri patients have abnormal changes in VEMPs (cervical and ocular) and to analyze the results and compare them with matched group of normal subjects.
Design: Ocular and cervical VEMPs were performed to the entire study groups. The responses were obtained from thirteen pseudotumor cerebri patients and compared to fifteen age matched normal subjects. All participants were subjected to audiological assessments that include pure tone audiometry, tympanometry and acoustic reflexes.
Results: Ocular and cervical VEMPs amplitudes were reduced in response in pseudotumor cerebri patients than normal but still of non-statistical significant difference p>0.05.
Discussion and Conclusion: The results of this study suggest that patients with pseudotumor cerebri do not have statistically significant changes in comparison with the normal control as regard ocular and cervical VEMPs testing. Hence, asserting a query whether there is affection of VEMPs in pseudotumor cerebri patients.
References
Wall M. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri). Current Neurology and Neuroscience Reports 2008; 8: 87-93. http://dx.doi.org/10.1007/s11910-008-0015-0
Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology 2002; 59: 1492-95. http://dx.doi.org/10.1212/01.WNL.0000029570.69134.1B
Rowe FJ, Sarkies NJ. The relationship between obesity and idiopathic intracranial hypertension. Int J Obes Relat Metab Disord 1999; 23: 54-9. http://dx.doi.org/10.1038/sj.ijo.0800758
Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri: population studies in iowa and louisiana. Arch Neurol 1988; 45: 875-7. http://dx.doi.org/10.1001/archneur.1988.00520320065016
Wall M. idiopathic intracranial hypertension. Neurol Clin 1991; 9: 73- 95.
Soler D, Cox T, Bullock P, Calver DM, Robinson RO. Diagnosis and management of benign intracranial hypertension. Arch Dis Child 1998; 78: 89-94. http://dx.doi.org/10.1136/adc.78.1.89
Karahalios DG, Rekate HL, Khayata MH, Apostolides PJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 1996; 46: 198-202. http://dx.doi.org/10.1212/WNL.46.1.198
Smith JL. Whence pseudotumor cerebri? J Clin Neuroophthalmol 1985; 5: 55-6.
Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past present and future. Clin Neurophysiol 2010; 121: 636-51. http://dx.doi.org/10.1016/j.clinph.2009.10.016
Murofushi T, Matsuzaki M, Mizuno M. Vestibular evoked myogenic potentials in patients with acoustic neuromas. Arch Otolaryngol Head Neck Surg 1998; 124: 509-12. http://dx.doi.org/10.1001/archotol.124.5.509
Colebatch JC, Rothwell JC, Bronstein A, Ludman H. Click evoked vestibular activation in the Tullio phenomenon. J Neuro Neurosur Psychiatr 1998; 57: 1538-40. http://dx.doi.org/10.1136/jnnp.57.12.1538
Murofushi T, Shemizu K, Takegoshi H, Cheng PW. Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol Head Neck Surg 2001; 127: 1069-72. http://dx.doi.org/10.1001/archotol.127.9.1069
Welgampola MS, Myrie OA, Minor LB, Carey JP. Vestibular-evoked myogenic potential thresholds normalize on plugging superior canal dehiscence. Neurology 2008; 70: 464-72. http://dx.doi.org/10.1212/01.wnl.0000299084.76250.4a
Colebatch JC, Halmagyi GM, Skuse NF. Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neuro Neurosur Psychiatr 1994; 57: 190-7. http://dx.doi.org/10.1136/jnnp.57.2.190
Todd NP, Rosengren SM, Aw ST, Colebatch JG. Ocular vestibular evoked myogenic potentials (oVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol 2007; 118(2): 381-90. http://dx.doi.org/10.1016/j.clinph.2006.09.025
Chihara Y, Iwasaki S, Ushio M, Murofushi T. Vestibular evoked extraocular potentials by air-conducted sound: another clinical test for vestibular function. Clin Neurophysiol 2007; 118(12): 2745-51. http://dx.doi.org/10.1016/j.clinph.2007.08.005
Taylor RL, Bradshaw AP, Halmagyi GM, Welgampola MS. Tuning characteristics of ocular and cervical vestibular evoked myogenic potentials in intact and dehiscent ears. Audiol Neurotol 2012; 17: 207-18. http://dx.doi.org/10.1159/000336959
Todd NPM, Cody FWJ, Banks JR. A saccular origin of frequency tuning in myogenic vestibular evoked potentials? Implications for human responses to loud sound. Hear Res 2000; 141: 180-8. http://dx.doi.org/10.1016/S0378-5955(99)00222-1
Welgampola MS, Colebatch JG. Characteristics of tone burst-evoked myogenic potentials in the sternocleidomastoid muscles. Otol Neurotol 2001; 22: 796-802. http://dx.doi.org/10.1097/00129492-200111000-00014
Rauch SD, Guangwei Z, Kujawa SG, Guinan JJ, Herrmann BS. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière’s disease. Otol Neurotol 2004; 25: 333-8. http://dx.doi.org/10.1097/00129492-200405000-00022
Iwasaki S, Smulders YE, Burgess AM, McGarvie LA, MacDougall HG, Halmagyi GM, Curthoys IS. Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects. Clin Neurophysiol 2008; 119: 2135-47. http://dx.doi.org/10.1016/j.clinph.2008.05.028
Murofushi T, Wakayama K, Chihara Y. oVEMP to air-conducted tones reflects functions of different vestibular populations from cVEMP? Eur Arch Otorhinolaryngol 2010; 267: 995-6. http://dx.doi.org/10.1007/s00405-010-1246-7
Iwasaki S, McGarvie LA, Halmagyi GM, et al. Head taps evoke a crossed vestibulo-ocular reflex. Neurology 2007; 68: 1227-9. http://dx.doi.org/10.1212/01.wnl.0000259064.80564.21
Welgampola MS, Rosengren SM, Halmagyi GM, Colebatch JG. Vestibular activation by bone conducted sound. J Neurol Neurosurg Psychiatry 2003; 74: 771-8. http://dx.doi.org/10.1136/jnnp.74.6.771
Lim LJZ, Dennis DL, Govender S, Colebatch JG. Differential effects of duration for ocular and cervical vestibular evoked myogenic potentials evoked by air- and bone-conducted stimuli. Exp Brain Res 2013; 224: 437-45. http://dx.doi.org/10.1007/s00221-012-3323-1
Wang S, Jaw F, Young Y. Ocular vestibular-evoked myogenic potentials elicited from monaural versus binaural acoustic stimulations. Clin Neurophysiol 2009; 120(2): 420-23. http://dx.doi.org/10.1016/j.clinph.2008.10.157
Brantberg K, Granath K, Schart N. Age-related changes in vestibular evoked myogenic potentials. Audiol Neurotol 2007; 12: 247-53. http://dx.doi.org/10.1159/000101332
Janky KL, Shepard N. Vestibular evoked myogenic potential (VEMP) testing: normative threshold response curves and effects of age. J Am Acad Audiol 2009; 20: 514-22. http://dx.doi.org/10.3766/jaaa.20.8.6
Akin FW, Murnane OD, Tampas JW, Clinard CG. The effect of age on the vestibular evoked myogenic potential and sternocleidomastoid muscle tonic electromyogram level. Ear Hear 2011; 32: 617-22. http://dx.doi.org/10.1097/AUD.0b013e318213488e
Rosengren SM, Govender S, Colebatch JG. Ocular and cervical vestibular evoked myogenic potentials produced by air- and bone-conducted stimuli: comparative properties and effects of age. Clin Neurophysiol 2011; 122: 2282-9. http://dx.doi.org/10.1016/j.clinph.2011.04.001
Velazquez-Villasenor L, Merchant SN, Tsuji K, Glynn RJ, Wall C 3rd, Rauch SD. Temporal bone studies of the human peripheral vestibular system. Normative Scarpa’s ganglion cell data. Ann Otol Rhinol Laryngol Suppl 2000; 181: 14-9.
Merchant SN, Velazquez-Villasenor L, Tsuji K, Glynn RJ, Wall C 3rd, Rauch SD. Temporal bone studies of the human peripheral vestibular system. Normative vestibular hair cell data. Ann Otol Rhinol Laryngol Suppl 2000; 181: 3-13.
Rauch SD, Velazquez-Villasenor L, Dimitri PS, Merchant SN. Decreasing hair cell counts in aging humans. Ann NY Acad Sci 2001; 942: 220-7. http://dx.doi.org/10.1111/j.1749-6632.2001.tb03748.x
Ross MD, Peacor D, Johnsson LG, Allard LF. Observations on normal and degenerating human otoconia. Ann Otol Rhinol Laryngol 1976; 85: 310-26. http://dx.doi.org/10.1177/000348947608500302
