Practice Guideline: Cervical and Ocular Vestibular Evokedmyogenic Potential Testing: Report of the Guideline Development Dissemination and Implementation Subcommittee of the American Academy of Neurology
Objective: To systematically review the evidence and make recommendations with regard to diagnostic utility of cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP, respectively). Four questions were asked: Does cVEMP accurately identify superior canal dehiscence syndrome (SCDS)? Does oVEMP accurately identify SCDS? For suspected vestibular symptoms, does cVEMP/oVEMP accurately identify vestibular dysfunction related to the saccule/ utricle? For vestibular symptoms, does cVEMP/oVEMP accurately and substantively aid diagnosis of any specific vestibular disorder besides SCDS? Methods: The guideline panel identified and classified relevant published studies (January 1980- December 2016) according to the 2004 American Academy of Neurology process. Results and Recommendations: Level C positive: Clinicians may use cVEMP stimulus threshold values to distinguish SCDS from controls (2 Class III studies) (sensitivity 86%-91%, specificity 90%-96%). Corrected cVEMP amplitude may be used to distinguish SCDS from controls (2 Class III studies) (sensitivity 100%, specificity 93%). Clinicians may use oVEMP amplitude to distinguish SCDS from normal controls (3 Class III studies) (sensitivity 77%-100%, specificity 98%-100%). oVEMP threshold may be used to aid in distinguishing SCDS from controls (3 Class III studies) (sensitivity 70%-100%, specificity 77%-100%). Level U: Evidence is insufficient to determine whether cVEMP and oVEMP can accurately identify vestibular function specifically related to the saccule/utricle, or whether cVEMP or oVEMP is useful in diagnosing vestibular neuritis or MÃ
Medical Subject Headings
Digital Object Identifier (DOI)
Fife, Terry D.; Colebatch, James G.; Kerber, Kevin A.; Brantberg, Krister; Strupp, Michael; Lee, Hyung; Walker, Mark F.; Ashman, Eric; Fletcher, Jeffrey; Callaghan, Brian; and Gloss, David S., "Practice Guideline: Cervical and Ocular Vestibular Evokedmyogenic Potential Testing: Report of the Guideline Development Dissemination and Implementation Subcommittee of the American Academy of Neurology" (2017). Neurology. 70.