Incorporating Vestibular Evoked Myogenic Potential (VEMP) assessment into our clinical practice

Abstract

Vestibular Evoked Myogenic Potentials (VEMPs) are short-latency electromyographic responses evoked by intense acoustic stimuli. They are measured in the ipsilateral, tonically-contracted sternocleidomastoid (SCM) muscle. The VEMP response is thought to arise from the vestibulocollic (also called sacculocollic) reflex. Since its introduction in 1992 (Colebatch et al.), VEMP testing is gradually becoming a part of standard vestibular assessment in many clinics. VEMPs have been found in response to various stimuli including loud clicks, short tone bursts, head taps and short duration DC currents presented to the mastoid. (Colebatch et al., 1994; Murofushi et al., 1996; Akin & Murnane, 2001; Cheng & Murofushi, 2001; Colebatch, 2001; de Waele, 2001; Ödkvist, 2001; Basta et al., 2005). The purpose of this article is to review the literature on VEMP testing in an effort to determine the clinical, best practice of their use. We will explore the recommended measurement parameters, what constitutes a normal response, how several types of pathology affect VEMPs and why we should consider incorporating VEMP assessment into our standard vestibular evaluation protocol