title: Vestibular evoked myogenic potentials and video head impulse test in patients with vertigo, dizziness and imbalance.
abstract: The aim of this study was to compare vestibular evoked myogenic potentials (VEMP) and video head impulse test (vHIT) results in patients presenting with vertigo and dizziness. We retrospectively analyzed data of all patients with the chief complaint of vertigo, dizziness, or imbalance that underwent VEMP and vHIT from January 2015 to January 2016. A total of 117 patients (73 females, mean age 53.92±16.76) fulfilled inclusion criteria: group 1 included patients with the final diagnosis of vestibular neuritis (VN) (N=31 (16 right and 15 left VN)), group 2 included patients with the final diagnosis of vertigo of central origin (N=23) and group 3 included patients with the final diagnosis of unspecified dizziness (N=63). There was significant correlation between oVEMP asymmetry and asymmetry of the lateral canals 60ms gains on vHIT (r=0.225, p=0.026). Significant correlation between oVEMP and vHIT asymmetry was present in VN patients (r=0.749, p<0.001), while no correlation was found in the groups 2 and 3. oVEMP and vHIT lateral canals asymmetries were significantly greater in patients with vestibular neuritis. Furthermore, positive correlations of oVEMP amplitudes with 60ms gain of the lateral semicircular canal and slope of the anterior semicircular canal on vHIT, and cVEMP with slope of the posterior semicircular canal on the vHIT were found. These changes were significantly more pronounced in patients with vestibular neuritis. In conclusion, VEMPs and vHIT data should be used complementarily; asymmetry on both tests strongly supports peripheral vestibular system involvement.
authors.affiliation: University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
authors.forename: Magdalena Krbot
authors.initials: MK
authors.lastname: Skorić
authors.affiliation: University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Adamec
authors.affiliation: School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Tin
authors.initials: T
authors.lastname: Pavičić
authors.affiliation: School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Pavlović
authors.affiliation: School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Berislav
authors.initials: B
authors.lastname: Ruška
authors.affiliation: School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Luka
authors.initials: L
authors.lastname: Crnošija
authors.affiliation: University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia. Electronic address: mhabek@mef.hr.
authors.forename: Mario
authors.initials: M
authors.lastname: Habek
mesh_terms: D000328:Adult; D000368:Aged; D004244:Dizziness / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D064087:Head Impulse Test / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000502:physiology; D014717:Vertigo / Q000175:diagnosis / Q000503:physiopathology*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D020338:Vestibular Neuronitis / Q000175:diagnosis / Q000503:physiopathology
keywords: Dizziness; Vertigo; Vestibular evoked myogenic potentials; Video head impulse test