Vestibular-evoked myogenic potentials in infancy and early childhood.
OBJECTIVE
Hearing impairment and the often concurrent loss of vestibular function, which is rarely assessed in infants, can both impair sensory integration critical to the development of normal motor coordination. This study demonstrates, for the first time, that vestibular function in infants can be noninvasively assessed using vestibular-evoked myogenic potentials (VEMPs). Our intentions were to demonstrate that VEMPs can be reliably recorded from neonates and to compare neonatal VEMPs with those obtained from normal adults.


METHODS
Prospective cohort study.


METHODS
Myogenic evoked potentials induced by air- and bone-conducted auditory stimuli were recorded from the sternocleidomastoid muscles of 12 normal neonates and 12 neonates with various clinical findings. These included infants with bilateral atresia of the external auditory canals, Treacher-Collins syndrome, and neonates who failed universal neonatal screening.


RESULTS
With the exception of one patient with hearing loss, reproducible biphasic VEMPs were recorded from the sternocleidomastoid muscle of all the infants using loud, short tone-burst sounds.


CONCLUSIONS
The VEMP has characteristics that differentiate it from the postauricular response and the Jaw reflex. The VEMPs were dominant on the side ipsilateral to the stimulated ear. The overall morphology of the neonatal VEMP is quite similar to that of adults. The major neonatal differences are a shorter latency of the n23 peak and higher amplitude variability. Our results suggest that recording of the VEMP in neonates with various audio-vestibular problems provides useful information about vestibular function in this population and may provide information that leads to better care and rehabilitation for neonates at risk of developmental and motor system delay.
Sheykholeslami
Kianoush
K
Department of Otolaryngology--Head and Neck Surgery, Case Western University, University of Tokyo, Japan [corrected]
Sheykholesami
Kianoush
K
Megerian
Cliff A
CA
Arnold
James E
JE
Kaga
Kimitaka
K
D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D002657:Child Development / Q000502:physiology; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000175:diagnosis; D004424:Ear Canal / Q000002:abnormalities*; D004576:Electromyography; D005072:Evoked Potentials, Auditory; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014724:Vestibular Function Tests; D014722:Vestibule, Labyrinth / Q000502:physiology