Vestibular evoked myogenic potentials in response to lateral skull taps are dependent on two different mechanisms.
OBJECTIVE
To explore the mechanisms for skull tap induced vestibular evoked myogenic potentials (VEMP).


METHODS
The muscular responses were recorded over both sternocleidomastoid (SCM) muscles using skin electrodes. A skull tapper which provided a constant stimulus intensity was used to test cervical vestibular evoked myogenic potentials (VEMP) in response to lateral skull taps in healthy subjects (n=10) and in patients with severe unilateral loss of vestibular function (n=10).


RESULTS
Skull taps applied approximately 2 cm above the outer ear canal caused highly reproducible VEMP. There were differences in VEMP in both normals and patients depending on side of tapping. In normals, there was a positive-negative ("normal") VEMP on the side contra-lateral to the skull tapping, but no significant VEMP ipsi-laterally. In patients, skull taps above the lesioned ear caused a contra-lateral positive-negative VEMP (as it did in the normals), in addition there was an ipsi-lateral negative-positive ("inverted") VEMP. When skull taps were presented above the healthy ear there was only a small contra-lateral positive-negative VEMP but, similar to the normals, no VEMP ipsi-laterally.


CONCLUSIONS
The present data, in conjunction with earlier findings, support a theory that skull-tap VEMP responses are mediated by two different mechanisms. It is suggested that skull tapping causes both a purely ipsi-lateral stimulus side independent SCM response and a bilateral and of opposite polarity SCM response that is stimulus side dependent. Possibly, the skull tap induced VEMP responses are the sum of a stimulation of two species of vestibular receptors, one excited by vibration (which is rather stimulus site independent) and one excited by translation (which is more stimulus site dependent).


CONCLUSIONS
Skull-tap VEMP probably have two different mechanisms. Separation of the two components might reveal the status of different labyrinthine functions.
Department of Audiology, Karolinska Hospital, 171 76 Stockholm, Sweden. krister.brantberg@karolinska.se
Krister
K
Brantberg
Magnus
M
Westin
Lennart
L
Löfqvist
Luca
L
Verrecchia
Arne
A
Tribukait
D000328:Adult; D004525:Efferent Pathways / Q000502:physiology; D004576:Electromyography / Q000379:methods; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D018069:Hair Cells, Vestibular / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D009334:Neck Muscles / Q000294:innervation / Q000502:physiology*; D009431:Neural Conduction / Q000502:physiology; D010812:Physical Stimulation / Q000379:methods; D012018:Reflex / Q000502:physiology; D012886:Skull / Q000502:physiology; D014724:Vestibular Function Tests; D014726:Vestibular Nuclei / Q000502:physiology*; D014722:Vestibule, Labyrinth / Q000502:physiology*; D055815:Young Adult