Evidence-based diagnostic use of VEMPs : From neurophysiological principles to clinical application.

BACKGROUND: Vestibular evoked myogenic potentials (VEMPs) are increasingly being used for testing otolith organ function.

OBJECTIVE: This article provides an overview of the anatomical, biomechanical and neurophysiological principles underlying the evidence-based clinical application of ocular and cervical VEMPs (oVEMPs and cVEMPs).

MATERIAL AND METHODS: Systematic literature search in PubMed until April 2019.

RESULTS: Sound and vibration at a frequency of 500 Hz represent selective vestibular stimuli for the otolith organs. The predominant specificity of oVEMPs for contralateral utricular function and of cVEMPs for ipsilateral saccular function is defined by the different central projections of utricular and saccular afferents. VEMPs are particularly useful in the diagnosis of superior canal dehiscence and otolith organ specific vestibular dysfunction and as an alternative diagnostic approach in situations when video oculography is not possible or useful.

CONCLUSION: The use of VEMPs is a simple, safe, reliable and selective test of dynamic function of otolith organs.