Ocular and cervical vestibular-evoked myogenic potentials in Tumarkin falls

Chi-Hsuan Huang, Yi-Ho Young
Otology & Neurotology 2012, 33 (7): 1251-6

OBJECTIVE: This study applied ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) tests in Ménière's patients with Tumarkin falls to investigate the etiologic role of the saccule/utricle in the event of Tumarkin falls.

STUDY DESIGN: Retrospective study.

SETTING: University hospital.

SUBJECTS: Twenty unilateral definite Ménière's patients were divided into 2 age- and sex-matched groups. Ten patients had a history of drop attacks, and 10 had no history of drop attacks.

MAIN OUTCOME MEASURES: All patients underwent audiometry and caloric, oVEMP, and cVEMP tests.

RESULTS: No significant differences were observed between the fall and nonfall groups in terms of Ménière staging, and caloric and cVEMP test results. In the fall group, oVEMP test via Fz tapping showed augmented, reduced, and absent responses in 1, 1, and 8 patients, respectively. In 3 of the latter 8 patients, however, oVEMPs could be obtained by lateral mastoid tapping. Thus, 100% of patients in the fall group had abnormal oVEMPs, which significantly differed from 50% oVEMP abnormalities in the nonfall group. Comparison of the abnormal results for the caloric, oVEMP, and cVEMP tests revealed that poorer residual vestibular function in the fall group than the nonfall group.

CONCLUSION: Absence of oVEMP by Fz tapping and presence of oVEMPs via lateral tapping indicates a residual utricular function. With residual canal function (canal paresis) and absent cVEMPs, subsequently residual utricular function may trigger the Tumarkin falls in Ménière's patients.

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