Vestibular Evoked Myogenic Potential (VEMP) Testing: How It Works And What To Expect

Vestibular Evoked Myogenic Potential

Vestibular Evoked Myogenic Potential (VEMP) Testing: How It Works And What To Expect

by | Apr 11, 2022 | Balance, Patient Resources

Falls account for about 50% of accidental deaths in the elderly and around 90 million Americans look to healthcare providers for solutions to vertigo, dizziness, or balance problems, the second most common complaint heard in doctors’ offices.

The causes of dizziness, vertigo, and disequilibrium can be hard to identify but are typically connected to a peripheral vestibular disorder (related to the inner ear) or central vestibular disorder (related to processing issues in the central nervous system).

Overcoming the accidents and additional problems related to disequilibrium requires accurate diagnosis and targeted treatment, which is why Pacific Hearing, Inc. has incorporated Vestibular Evoked Myogenic Potential (VEMP) testing into our diagnostic services.

How does VEMP testing work and what should you expect to take place during testing?

Understanding Vestibular Dysfunction, Symptoms, And Causes

For a more complete understanding of VEMP testing, it is necessary to have a better understanding of vestibular dysfunction, which is a disturbance in the body’s balance system due to either peripheral or central causes.

Sensory input from your vision, touch sensors in the feet, trunk, and spine, and the vestibular system in your inner ear work together to provide positional signals to the central vestibular system, which processes those signals and communicates to other parts of the body to make adjustments that help you remain steady on your feet.

Although symptoms such as dizziness, vertigo, nausea, vomiting, intolerance to head motion, nystagmus, unsteady gait, and postural instability can come from non-vestibular dysfunction causes, they are quite common to vestibular dysfunction.

The symptoms of vestibular dysfunction can be caused by many conditions, but among the most common are acoustic neuroma, benign paroxysmal positional vertigo (BPPV), labyrinthitis and vestibular neuritis, Mal de débarquement syndrome, Ménière’s disease, and otitis media, which is common in children.

What Is VEMP Testing?

The vestibular evoked myogenic potential reflex is produced by the inferior vestibular nerve, which provides evidence of the integrity of the vestibular response. It is this reflex that VEMP testing measures.

VEMP testing is a relatively new means of vestibular evaluation, receiving FDA approval in 2015. Although the diagnostic utility and the scientific evidence supporting the use of VEMP testing is still being investigated, two primary VEMP responses receive the most attention.

Cervical VEMP, also known as a cVEMP, and ocular VEMP, or oVEMP, are responses that measure otolith function (linear sensors of the inner ear). Assessing the saccular function and inferior branch of the vestibular nerve involves the use of cVEMP testing, while assessing the utricular function and the superior branch of the vestibular nerve are done using oVEMP.

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What Happens During A VEMP Test?

Vestibular Evoked Myogenic Potential (VEMP) testing is in conjunction with the VNG evaluation for patients experiencing dizziness or balance problems.

During the VEMP test, you will recline at an angle with sticker electrodes attached to your head and neck. As you lift your head slightly, you will hear a knocking sound, which is measured by the electrodes.

By lowering the knocking to see if one ear is more sensitive than the other or by testing only one ear at a time, we are able to localize the side that may be involved in causing the dizziness or imbalance.

What Does The VEMP Test Diagnose?

Although it’s not the sole tool for diagnosis in most conditions related to dizziness, vertigo, and balance disorders, VEMP testing is typically used to aid in conjunction with VNG testing in the evaluation of conditions like vestibular neuritis (inflammation of the vestibular nerve) and Meniere’s disease (fluid abnormality of the ear).

Patients affected by vestibular migraines show an absent or reduced VEMP amplitude in one or both ears, motivating additional investigation into the relationship between VEMPs.

This form of testing has also been used for the early identification of demyelinating disorders, such as multiple sclerosis, leading to treatments designed to prevent the rapid decline and development of disabilities.

VEMP testing can also aid in the diagnosis of superior semicircular canal dehiscence (SSCD), caused by a leakage of pressure and/or fluid from the inner ear structures. It is another condition that produces symptoms of vestibular dysfunction as well as difficulty focusing the eyes, hearing loss, and sound sensitivity issues.

The primary purpose of VEMP testing used by your audiologist is to determine if the saccule and the vestibular nerve are intact and functioning properly. When functioning at their best, the saccule and the inferior vestibular nerves work together to send signals to the muscles of the eyes in response to head movements.

VEMP Testing Provided By Pacific Hearing, Inc.

As a part of our commitment to provide the highest possible level of hearing care to our patients, Pacific Hearing, Inc. makes use of advanced technology tools to provide the most accurate diagnosis of conditions related to your hearing and balance.

A clearer picture provided by VEMP testing enhances our capacity to provide personalized treatment that targets your unique needs.

If you or a loved one is experiencing dizziness, vertigo, or balance issues, click here to learn more about VEMP testing, vestibular dysfunction, and how our doctors of audiology can help you get the relief you need.

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Gregory Frazer, PhD, AuD, CCC-A, ABA, NBC-HIS

Adjunct Professor UCSD/San Diego State U Audiology Program Adjunct Professor University of Pacific Audiology Program Adjunct Professor AT Still University Audiology Program Adjunct Professor Pacific University Audiology Program Dr. Gregory Frazer entered private practice Audiology and Hearing Aid Dispensing in 1982. For 14 years he owned and operated Hearing Care Associates, which had 23 offices and was one of the largest audiology private practices in the U.S. Dr. Frazer is a well-known clinician and teacher and was the first audiologist to obtain dual doctorates in Audiology, both a PhD. in Audiology as well as the new Clinical Doctorate of Audiology, the AuD. He is Board Certified by the American Speech-Language-Hearing Association, American Academy of Audiology, and the National Certification in Hearing Instrument Sciences. Dr. Frazer specializes in the evaluation and treatment of vertigo, dizziness, and hearing and balance disorders. Dr. Frazer is experienced in working with infants, children, and adults. He is semi-fluent in Spanish and Sign Language.

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