Can vestibular-evoked myogenic potentials help differentiate ménière disease from vestibular migraine?

M. Geraldine Zuniga, Kristen L. Janky, Michael C. Schubert, John P. Carey

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Objectives. To characterize both cervical and ocular vestibular-evoked myogenic potential (cVEMP, oVEMP) responses to air-conducted sound (ACS) and midline taps in Ménière disease (MD), vestibular migraine (VM), and controls, as well as to determine if cVEMP or oVEMP responses can differentiate MD from VM.Study Design. Prospective cohort study.Setting. Tertiary referral center.Subjects and Methods. Unilateral definite MD patients (n = 20), VM patients (n = 21) by modified Neuhauser criteria, and age-matched controls (n = 28). cVEMP testing used ACS (clicks), and oVEMP testing used ACS (clicks and 500-Hz tone bursts) and midline tap stimuli (reflex hammer and Mini-Shaker). Outcome parameters were cVEMP peak-to-peak amplitudes and oVEMP n10 amplitudes.Results. Relative to controls, MD and VM groups both showed reduced click-evoked cVEMP (P <.001) and oVEMP (P <.001) amplitudes. Only the MD group showed reduction in tone-evoked amplitudes for oVEMP. Tone-evoked oVEMPs differentiated MD from controls (P =.001) and from VM (P =.007). The oVEMPs in response to the reflex hammer and Mini-Shaker midline taps showed no differences between groups (P >.210).Conclusions. Using these techniques, VM and MD behaved similarly on most of the VEMP test battery. A link in their pathophysiology may be responsible for these responses. The data suggest a difference in 500-Hz tone burst-evoked oVEMP responses between MD and MV as a group. However, no VEMP test that was investigated segregated individuals with MD from those with VM.

Original languageEnglish (US)
Pages (from-to)788-796
Number of pages9
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume146
Issue number5
DOIs
StatePublished - May 1 2012

Fingerprint

Vestibular Diseases
Vestibular Evoked Myogenic Potentials
Migraine Disorders
Air
Tertiary Care Centers
Reflex
Cohort Studies
Prospective Studies

Keywords

  • Ménière disease
  • VEMP
  • hydrops
  • otolith
  • saccule
  • utricle
  • vestibular migraine

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Can vestibular-evoked myogenic potentials help differentiate ménière disease from vestibular migraine? / Zuniga, M. Geraldine; Janky, Kristen L.; Schubert, Michael C.; Carey, John P.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 146, No. 5, 01.05.2012, p. 788-796.

Research output: Contribution to journalArticle

@article{c8f2542de8284976b96b763855a381fb,
title = "Can vestibular-evoked myogenic potentials help differentiate m{\'e}ni{\`e}re disease from vestibular migraine?",
abstract = "Objectives. To characterize both cervical and ocular vestibular-evoked myogenic potential (cVEMP, oVEMP) responses to air-conducted sound (ACS) and midline taps in M{\'e}ni{\`e}re disease (MD), vestibular migraine (VM), and controls, as well as to determine if cVEMP or oVEMP responses can differentiate MD from VM.Study Design. Prospective cohort study.Setting. Tertiary referral center.Subjects and Methods. Unilateral definite MD patients (n = 20), VM patients (n = 21) by modified Neuhauser criteria, and age-matched controls (n = 28). cVEMP testing used ACS (clicks), and oVEMP testing used ACS (clicks and 500-Hz tone bursts) and midline tap stimuli (reflex hammer and Mini-Shaker). Outcome parameters were cVEMP peak-to-peak amplitudes and oVEMP n10 amplitudes.Results. Relative to controls, MD and VM groups both showed reduced click-evoked cVEMP (P <.001) and oVEMP (P <.001) amplitudes. Only the MD group showed reduction in tone-evoked amplitudes for oVEMP. Tone-evoked oVEMPs differentiated MD from controls (P =.001) and from VM (P =.007). The oVEMPs in response to the reflex hammer and Mini-Shaker midline taps showed no differences between groups (P >.210).Conclusions. Using these techniques, VM and MD behaved similarly on most of the VEMP test battery. A link in their pathophysiology may be responsible for these responses. The data suggest a difference in 500-Hz tone burst-evoked oVEMP responses between MD and MV as a group. However, no VEMP test that was investigated segregated individuals with MD from those with VM.",
keywords = "M{\'e}ni{\`e}re disease, VEMP, hydrops, otolith, saccule, utricle, vestibular migraine",
author = "Zuniga, {M. Geraldine} and Janky, {Kristen L.} and Schubert, {Michael C.} and Carey, {John P.}",
year = "2012",
month = "5",
day = "1",
doi = "10.1177/0194599811434073",
language = "English (US)",
volume = "146",
pages = "788--796",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Can vestibular-evoked myogenic potentials help differentiate ménière disease from vestibular migraine?

AU - Zuniga, M. Geraldine

AU - Janky, Kristen L.

AU - Schubert, Michael C.

AU - Carey, John P.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Objectives. To characterize both cervical and ocular vestibular-evoked myogenic potential (cVEMP, oVEMP) responses to air-conducted sound (ACS) and midline taps in Ménière disease (MD), vestibular migraine (VM), and controls, as well as to determine if cVEMP or oVEMP responses can differentiate MD from VM.Study Design. Prospective cohort study.Setting. Tertiary referral center.Subjects and Methods. Unilateral definite MD patients (n = 20), VM patients (n = 21) by modified Neuhauser criteria, and age-matched controls (n = 28). cVEMP testing used ACS (clicks), and oVEMP testing used ACS (clicks and 500-Hz tone bursts) and midline tap stimuli (reflex hammer and Mini-Shaker). Outcome parameters were cVEMP peak-to-peak amplitudes and oVEMP n10 amplitudes.Results. Relative to controls, MD and VM groups both showed reduced click-evoked cVEMP (P <.001) and oVEMP (P <.001) amplitudes. Only the MD group showed reduction in tone-evoked amplitudes for oVEMP. Tone-evoked oVEMPs differentiated MD from controls (P =.001) and from VM (P =.007). The oVEMPs in response to the reflex hammer and Mini-Shaker midline taps showed no differences between groups (P >.210).Conclusions. Using these techniques, VM and MD behaved similarly on most of the VEMP test battery. A link in their pathophysiology may be responsible for these responses. The data suggest a difference in 500-Hz tone burst-evoked oVEMP responses between MD and MV as a group. However, no VEMP test that was investigated segregated individuals with MD from those with VM.

AB - Objectives. To characterize both cervical and ocular vestibular-evoked myogenic potential (cVEMP, oVEMP) responses to air-conducted sound (ACS) and midline taps in Ménière disease (MD), vestibular migraine (VM), and controls, as well as to determine if cVEMP or oVEMP responses can differentiate MD from VM.Study Design. Prospective cohort study.Setting. Tertiary referral center.Subjects and Methods. Unilateral definite MD patients (n = 20), VM patients (n = 21) by modified Neuhauser criteria, and age-matched controls (n = 28). cVEMP testing used ACS (clicks), and oVEMP testing used ACS (clicks and 500-Hz tone bursts) and midline tap stimuli (reflex hammer and Mini-Shaker). Outcome parameters were cVEMP peak-to-peak amplitudes and oVEMP n10 amplitudes.Results. Relative to controls, MD and VM groups both showed reduced click-evoked cVEMP (P <.001) and oVEMP (P <.001) amplitudes. Only the MD group showed reduction in tone-evoked amplitudes for oVEMP. Tone-evoked oVEMPs differentiated MD from controls (P =.001) and from VM (P =.007). The oVEMPs in response to the reflex hammer and Mini-Shaker midline taps showed no differences between groups (P >.210).Conclusions. Using these techniques, VM and MD behaved similarly on most of the VEMP test battery. A link in their pathophysiology may be responsible for these responses. The data suggest a difference in 500-Hz tone burst-evoked oVEMP responses between MD and MV as a group. However, no VEMP test that was investigated segregated individuals with MD from those with VM.

KW - Ménière disease

KW - VEMP

KW - hydrops

KW - otolith

KW - saccule

KW - utricle

KW - vestibular migraine

UR - http://www.scopus.com/inward/record.url?scp=84864021786&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864021786&partnerID=8YFLogxK

U2 - 10.1177/0194599811434073

DO - 10.1177/0194599811434073

M3 - Article

C2 - 22267492

AN - SCOPUS:84864021786

VL - 146

SP - 788

EP - 796

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 5

ER -