Practice Guideline: Cervical and Ocular Vestibular Evoked Myogenic Potential Testing: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
Neurology
Fife, T. D., Colebatch, J. G., et al. (2017).
Neurology, 89(22), 2288-2296.
This practice guideline provides recommendations regarding the use of cervical and ocular vestibular evoked myogenic potentials to identify superior canal dehiscence syndrome and other vestibular disorders.
American Academy of Neurology
<p>Cervical vestibular evoked myogenic potentials (cVEMP) threshold values, corrected cVEMP amplitude, ocular vestibular evoked myogenic potentials (oVEMP) amplitude, and oVEMP threshold values can be used for identifying superior canal dehiscence syndrome (SCDS) in patients (Class III Evidence, Level C positive). cVEMP and oVEMP demonstrate the ability to distinguish patients with SCDS from control patients as follows:</p>
<ul>
<li>cVEMP threshold values demonstrate sensitivity ranging from 86% to 91% and specificity ranging from 90% to 96%. Corrected cVEMP amplitude demonstrates sensitivity of 100% and specificity of 93% (Class III Evidence).</li>
<li>oVEMP amplitude shows sensitivity ranging from 77% to 100% and specificity from 98% to 100%. oVEMP threshold shows sensitivity of 77% and specificity of 93% (Class III Evidence).</li>
</ul>
No recommendation for or against the use of cVEMP or oVEMP in identifying or diagnosing saccule or utricular dysfunction, vestibular neuritis, and Ménière disease can be made (No relevant studies, Level U). There is insufficient evidence investigating whether cVEMP and oVEMP can accurately identify saccular or utricular dysfunction (No relevant studies). Evidence investigating the ability of cVEMP and oVEMP to diagnose vestibular neuritis or Ménière disease is also lacking (No relevant studies).
Cervical vestibular evoked myogenic potentials (cVEMP) should not be used for diagnosing benign paroxysmal positional vertigo (BPPV) in patients (Class III Evidence, Level C negative). Evidence demonstrates that cVEMP lacks the ability to distinguish patients with BPPV from controls (Class III Evidence).
