Topographical correlations of lateral medullary infarction with caloric- and vestibular-evoked myogenic potential results

Tseng, Chih-Lung; Young, Yi‐Ho

doi:10.1007/s00405-009-1025-5

Cited by 13 publications

(15 citation statements)

References 10 publications

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“…In contrast to the cVEMPs, caloric tests evaluate the ascending horizontal VOR originating from the horizontal semicircular canal [20]. Therefore, in LMI, topographical correlations could be made that caloric paresis is more likely linked to rostrally located infarctions while absent or delayed cVEMPs may indicate caudally located ones [24]. The contralesional or bilateral abnormalities of cVEMPs in patients with unilateral LMI were ascribed to disruption of commissural modulation between the vestibular nuclei [23].…”

Section: Lateral Medullary Infarction (Wallenberg Syndrome)mentioning

confidence: 97%

Vestibular-evoked myogenic potentials in central vestibular disorders

Kim

2015

J Neurol

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Vestibular-evoked myogenic potentials (VEMPs) are short latency manifestations of vestibuloocular and vestibulocollic reflexes that originate from the utricle and saccule. Although cervical and ocular VEMPs have mostly been applied to peripheral vestibular disorders, the characteristics and the diagnostic values of VEMPs have been expanded to assess the function of the central otolithic pathways. In the central nervous system, the cervical VEMPs (cVEMPs) are mediated by the vestibular nuclei and uncrossed medial vestibulospinal tract descending in the lower brainstem and spinal cord. In contrast, the ocular VEMPs (oVEMPs) reflect the function of the vestibular nuclei and the crossed vestibulo-ocular reflex (VOR) pathways, mostly contained in the medial longitudinal fasciculus (MLF). Therefore, lesions involving the vestibular nuclei can present abnormalities of both cVEMPs and oVEMPs. The medullary lesions involving the descending MLF or the spinal accessory nucleus impair cVEMPs. In contrast, the lesions involving the MLF, the crossed ventral tegmental tract, oculomotor nuclei and the interstitial nucleus of Cajal can impair oVEMPs. Patients with unilateral cerebellar infarctions may show abnormal VEMPs especially when they have the ocular tilt reaction. Delayed responses of VEMPs are characteristic of multiple sclerosis (MS). Reduced VEMP responses can be observed in patients with vestibular migraine. VEMPs are useful in evaluating central as well as peripheral otolithic function that are not readily defined by conventional vestibular function tests, and can aid in detecting and localizing central lesions, especially silent brainstem lesions such as tiny infarctions or MS plaques.

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Section: Lateral Medullary Infarction (Wallenberg Syndrome)mentioning

confidence: 97%

Vestibular-evoked myogenic potentials in central vestibular disorders

Kim

2015

J Neurol

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“…Topographical study of PICA territory infarction revealed that absent or delayed cVEMPs relate to caudally located infarction, while caloric areflexia may be linked with rostrally located infarction [19]. However, the cVEMP and caloric tests have various output expressions such as VEMP waveform and caloric nystagmus, which means that the results of the two tests cannot be compared.…”

Section: Discussionmentioning

confidence: 98%

Mapping affected territory of anterior/posterior inferior cerebellar artery infarction using a vestibular test battery

Weng

Young

2014

Acta Oto-Laryngologica

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In the PICA group, 8 (36%) of 22 ears had a mean hearing level >25 dB. All six ears (100%) in the AICA group had abnormal hearing, and thus both groups revealed a significant difference. Conversely, significant differences were not observed in the vestibular test battery between the PICA and AICA groups. MRI demonstrated infarction at the brainstem for six patients, while one patient also had cerebellar involvement, indicated by loss of visual suppression on caloric nystagmus. Six patients showed infarction at the cerebellum, and four of them had brainstem affliction based on abnormal oVEMP/cVEMP test results.

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“…In a patient with cerebellar cavernoma (Patient 12), normal caloric responses with delayed cVEMPs (Fig. 1) may indicate a lower brainstem lesion (23). Visual suppression during the caloric test may help to evaluate the involvement of the cerebellum via affecting the floccular Purkinje cells of cerebellum, which, in turn, inhibit the superior and medial vestibular nuclei (24).…”

Section: Audiovestibular Function Testingmentioning

confidence: 98%