Idiopathic intracranial hypertension: Ocular vestibular evoked myogenic potentials as a new evaluation tool

Gürkov, Robert; Wittwer, Luis; Speierer, Guillaume; Müri, René M.; Mantokoudis, Georgios; Kalla, Roger

doi:10.1016/j.clinph.2017.07.415

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Reduction in ICP by lumbar cerebrospinal fluid (CSF) drainage has a systemic effect on VEMP amplitudes. Increasing ICP systematically alters oVEMP in terms of absolute amplitudes and frequency tuning characteristics (36)(37)(38)(39). In this report, in terms of differences in oVEMP parameters between children with EVA and those with a normal cochlea, we speculated that the presence of a third window in the inner ear labyrinth might allow for activation of vestibular receptors in LVAS patients (40).…”

Section: Discussionmentioning

confidence: 68%

Influence of Cochlear Implantation on Vestibular Function in Children With an Enlarged Vestibular Aqueduct

et al. 2021

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Background: Cochlear implantation (CI) is becoming increasingly used in the rehabilitation of hearing-impaired patients. Children with an enlarged vestibular aqueduct (EVA) need CI for severe or profound hearing loss, with excellent outcomes in hearing rehabilitation. However, vestibular function influenced by CI in children with EVA has not been clarified. We compared the characteristics of vestibular function in implanted children with EVA and those with a normal cochlea.Methods: In this retrospective case-control study, 16 children with large vestibular aqueduct syndrome (LVAS) and 16 children with a normal cochlea were recruited as the Study and Control Group, respectively. All children (mean age, 10.3 ± 4.4 years) had bilateral profound sensorineural hearing loss (SNHL) and normal pre-operative vestibular functions and underwent unilateral CI. Otolith and canal functions were assessed before CI and 12 months thereafter. Cervical vestibular-evoked myogenic potential (cVEMP), ocular vestibular-evoked myogenic potential (oVEMP), and video head impulse test (vHIT) were evaluated.Results: Full insertion of the electrode array was achieved in all the cases. Preoperatively, no significant differences in parameters in cVEMP between the Study and Control Group were revealed (p > 0.05). In pre-operative oVEMP, shorter N1 latencies (p = 0.012), shorter P1 latencies (p = 0.01), and higher amplitudes (p = 0.001) were found in the Study than in the Control Group. The Study Group had shorter P1 latency in cVEMP (p = 0.033), and had lower amplitude in oVEMP after implantation (p = 0.03). Statistically significant differences were not found in VOR gains of all three semicircular canals before and after surgery (p > 0.05). VEMP results revealed that the Control Group had significantly lower deterioration rates after CI (p < 0.05). The surgical approach and electrode array had no statistically significant influence on the VEMP results (p > 0.05).Conclusion: oVEMP parameters differed between children with EVA and children with a normal cochlea before surgery. Systematic evaluations before and after CI showed that otolith function was affected, but all three semicircular canals functions were essentially undamaged after implantation. In contrast to subjects with a normal cochlea, children with EVA are more likely to preserve their saccular and utricular functions after CI surgery. Possible mechanisms include less pressure-related damage, a reduced effect in terms of the air-bone gap (ABG), or more sensitivity to acoustic stimulation.

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Section: Discussionmentioning

confidence: 68%

Influence of Cochlear Implantation on Vestibular Function in Children With an Enlarged Vestibular Aqueduct

et al. 2021

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Section: Discussionmentioning

confidence: 84%

“…Bone conducted vibration, not primarily relying on this sound transmission system, was not affected. 13 Reduced persistence and amplitude of the oVEMPs have also been demonstrated in experimentally increased intracranial pressure studies. 14,15 In the cVEMP study amplitude changes, prolonged latencies, or absent responses have been reported because of perilymphatic and endolymphatic pressure alterations in response to elevated intracranial pressure.…”

Section: Discussionmentioning

confidence: 84%

Cervical Vestibular Evoked Myogenic Potentials in Idiopathic Intracranial Hypertension

Uyaroğlu

Ucar

Şengül

et al. 2020

Journal of Clinical Neurophysiology

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Purpose:Idiopathic intracranial hypertension (IIH) is raised intracranial pressure without any identifiable etiology. The inner ear structures are susceptible to cerebrospinal fluid (CSF) pressure changes because of connections between the CSF space and the labyrinth to explain the audiovestibular symptoms, such as pulsatile tinnitus or dizziness, reported in 50% to 60% of these patients. The aim of this study was to investigate the vestibular functions using cervical vestibular evoked myogenic potentials (cVEMPs) in IIH.Methods:cVEMPs were recorded in 30 patients with IIH before lumbar puncture. Thirty healthy volunteers constituted the control group. The latencies of peaks p13 and n23 and peak-to-peak amplitude of p13–n23 were measured.Results:Responses were gathered bilaterally from all healthy controls. In 30 patients with IIH, 49 responses could be gathered from 60 tests (81.7%). The potential was absent bilaterally in five and unilaterally in one patient. When recorded, the latency and amplitude values of the responses of the patients were not significantly different from the healthy controls (P > 0.005). A correlation between CSF pressure and response persistence could not be determined.Conclusions:cVEMPs are affected in patients with IIH and the main finding is the absence of the responses. Increased intracranial pressure causing sound transmission changes within the inner ear can affect the saccular afferents and may end up with absent responses on air-conducted cVEMP recordings. To comment on the correlation between the CSF pressure and cVEMP changes, successive cVEMP recordings with longitudinal CSF pressure monitoring seem necessary.

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Evaluation of the audiovestibular system before and after treatment in patients with Idiopathic intracranial hypertension

Karaketir,

Berkiten,

Tutar

et al. 2024

Acta Oto-Laryngologica

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Idiopathic intracranial hypertension: Ocular vestibular evoked myogenic potentials as a new evaluation tool

Cited by 4 publications

References 6 publications

Influence of Cochlear Implantation on Vestibular Function in Children With an Enlarged Vestibular Aqueduct

Influence of Cochlear Implantation on Vestibular Function in Children With an Enlarged Vestibular Aqueduct

Cervical Vestibular Evoked Myogenic Potentials in Idiopathic Intracranial Hypertension

Evaluation of the audiovestibular system before and after treatment in patients with Idiopathic intracranial hypertension

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