Ocular VEMPs indicate repositioning of otoconia to the utricle after successful liberatory maneuvers in benign paroxysmal positioning vertigo.
CONCLUSIONS
This study showed a transient increase of ocular vestibular evoked myogenic potential (oVEMP) amplitudes in the affected ear after successful liberatory maneuvers and no changes in cervical VEMP (cVEMP) amplitudes. These findings support the hypothesis that successful liberatory maneuvers can lead to a repositioning of otoconia to the utricle.


OBJECTIVE
To evaluate whether oVEMP amplitudes increase after successful liberatory maneuvers in patients with posterior semicircular canal benign paroxysmal positioning vertigo (pc-BPPV), while cVEMP amplitudes do not change. These findings may indicate a successful repositioning of dislodged otoconia to the utricular macula, but not to the saccular macula.


METHODS
Thirty patients with unilateral pc-BPPV were prospectively examined with bone-conducted oVEMP and air-conducted cVEMP at four time points: before, after, 1 week after, and 1 month after the liberatory maneuvers (Sémont maneuvers).


RESULTS
At the 1-week follow-up, 20 of 30 patients were asymptomatic (responders); BPPV could still be induced in the other 10 (non-responders). In responders the mean n10 amplitude on the affected side increased from 12 ± 6.5 µV at baseline (before the treatment) to 15.9 ± 7.1 µV at 1 week after treatment; this increase was significantly (p = 0.001) higher in responders than in non-responders. cVEMP did not differ significantly.
German Center for Vertigo and Balance Disorders, University Hospital Munich , Germany.
Tatiana
T
Bremova
Otmar
O
Bayer
Yuri
Y
Agrawal
Olympia
O
Kremmyda
Thomas
T
Brandt
Julian
J
Teufel
Michael
M
Strupp
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065635:Benign Paroxysmal Positional Vertigo; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010037:Otolithic Membrane / Q000503:physiopathology; D056888:Patient Positioning; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D012444:Saccule and Utricle / Q000503:physiopathology*; D014717:Vertigo / Q000503:physiopathology / Q000534:rehabilitation*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D014724:Vestibular Function Tests / Q000379:methods*