Ocular versus cervical vestibular evoked myogenic potentials in different stages of Meniere’s disease

BackgroundThe vestibular evoked myogenic potential recorded from cervical muscles (cVEMP), proved to be a useful tool in assessment of the availability of the saccular function. Recently, the emergence of VEMP recording from the extra-ocular muscles (oVEMP) promises to test both saccular and utricular function when they are evoked by air conduction and bone conduction stimuli, respectively.ObjectivesThe current work was designed to assess the feasibility of recording oVEMP versus cVEMP in Meniere’s patients; moreover, to relate such recordings to the stage of the disease.MethodsTwenty-eight middle-aged subjects of both genders with unilateral definite Meniere’s disease were involved as a study group. A control group of 20 normal middle-aged subjects was examined too. The oVEMP via air conduction and bone conduction stimulation and cVEMP via air conduction were recorded for both groups.ResultsAll types of VEMP recording were highly reproducible among control subjects. However, they were mostly impaired or even absent in subjects with Meniere’s disease. The latency difference whether between control group and the whole study group ears or between control group ears and affected ears in each stage separately, revealed statistically significant difference of little clinical importance. The picture was different in amplitude measurement, which revealed significant difference between control and study group of both statistical and clinical values. Both of cVEMP and oVEMP recorded via air conduction stimulation has paralleled each other during the course of the pathology while affection of oVEMP recorded via bone conduction stimulation showed in the second stage of the disease.ConclusionoVEMP via air conduction and bone conduction stimulation was highly reproducible among normal population. oVEMP and cVEMP were affected in patients of Meniere’s disease and revealed more impairment when progressing into advancing stages.