Pathological eye movements influence on the recordings of ocular vestibular-evoked myogenic potential

Abstract

Objective: This study investigated the influence of pathological eye movements on the recordings of ocular vestibulo-evoked myogenic potential (oVEMP).

Methods: Ten patients with pathological eye movements of non-vestibular origin (nine congenital nystagmus and one opsoclonus) who had negative MRI result were assigned to Group A. Another 20 vestibular neuritis (VN) patients with spontaneous nystagmus were assigned to Group B. Both groups underwent audiometry, and caloric, oVEMP and cervical VEMP (cVEMP) tests.

Results: In Group A, the caloric, oVEMP and cVEMP tests showed 40%, 55% and 50% abnormalities, respectively. In Group B (VN), caloric, oVEMP and cVEMP tests revealed 100%, 80% and 45% abnormalities on the lesion ears, and 0%, 40% and 0% abnormalities on the healthy (opposite) ears, respectively. The 40% oVEMP abnormality on the healthy ears may be due to recording failure from the presence of spontaneous nystagmus, since five of five VN patients showed normal oVEMPs on the healthy ears, one year after presentation.

Conclusions: Presence of pathological eye movements may affect the recordings of oVEMP. Thus, the oVEMP test is recommended to perform after acute vertiginous episode to exclude the influence of pathological eye movements on the oVEMP recordings.

Chinese abstract

目的: 本研究调查病理性眼动对眼前庭诱发的生肌电位 (oVEMP) 记录的影响。

方法: 将具有阴性MRI结果的非前庭起源的病理性眼动的10名患者 (9位患先天性眼球震颤, 1位患opsoclonus) 分配至A组。将另外20名具有自发性眼球震颤的前庭神经炎 (VN) 患者分配至B组。对两组进行听力测定, 以及热量、oVEMP和颈部VEMP (cVEMP) 测试。

结果: 在A组中, 热量、oVEMP和cVEMP测试分别显示40%、55%和50%异常。在B组 (VN) 中, 热量、oVEMP和cVEMP测试显示, 病变耳有100%、80%和45%异常, 健康 (相对) 耳有0%、40%和0%异常。健康耳的40%oVEMP异常可能是由于自发性眼球震颤的存在而导致的记录失败, 因为一年之后5个VN患者中的5个的健康耳显示正常的oVEMP。

结论: 病理性眼动的存在可能影响oVEMP的记录。因此, 建议oVEMP测试在急性眩晕发作之后进行, 以排除病理性眼动对oVEMP记录的影响。

Keywords:

• Congenital nystagmus
• ocular vestibulo-evoked myogenic potential (oVEMP)
• opsoclonus
• vestibular neuritis

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

This work was funded by the National Science Council (Taiwan) (Grant no. Most 104-2314-B-002-153-MY3).