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2013 ; 133
(12
): 1297-303
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Ocular VEMPs indicate repositioning of otoconia to the utricle after successful
liberatory maneuvers in benign paroxysmal positioning vertigo
#MMPMID24245699
Bremova T
; Bayer O
; Agrawal Y
; Kremmyda O
; Brandt T
; Teufel J
; Strupp M
Acta Otolaryngol
2013[Dec]; 133
(12
): 1297-303
PMID24245699
show ga
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. OBJECTIVES: 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.