Cervical vestibular evoked myogenic potentials in patients with the first episode of posterior canal benign paroxysmal positional vertigo before and after repositioning

Acta Otolaryngol. 2021 Feb;141(2):147-151. doi: 10.1080/00016489.2020.1837393. Epub 2020 Nov 5.

Abstract

Background: Cervical vestibular evoked myogenic potentials (cVEMPs) are used to assess the sacculo-collic pathways. Benign paroxysmal positional vertigo (BPPV) is mainly a utricular disorder.

Objectives: To investigate cVEMPs in BPPV patients before and after repositioning maneuvers.

Methods: Forty patients with posterior canal BPPV with new onset symptoms underwent cVEMP testing at the time of diagnosis and a month after successful repositioning maneuver. p13, n23 latency and amplitude ratio values were compared with the results of 40 healthy controls.

Results: p13 and n23 latencies of the affected side were significantly longer than the healthy controls more prominent for the p13 latency. Comparison of the affected side with the non-affected side revealed delayed p13 latency on the affected side. Though a significant improvement in p13 latency was observed after repositioning, it was still prolonged when compared with the healthy controls. An abnormality regarding amplitudes was not present.

Conclusions and significance: cVEMP abnormalities in patients with BPPV indicate saccular dysfunction accompanying utricular dysfunction which seems to be confined to the symptomatic side at least in the early phase of the disease. Partial recovery can be seen after treatment with residual findings following even the first attack.

Keywords: Benign paroxysmal positional vertigo; cervical vestibular evoked myogenic potentials; posterior semicircular canal; repositioning maneuver.

MeSH terms

  • Adult
  • Aged
  • Benign Paroxysmal Positional Vertigo / physiopathology*
  • Case-Control Studies
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Patient Positioning
  • Reference Values
  • Vestibular Evoked Myogenic Potentials / physiology*
  • Vestibular Function Tests