Utilidad clínica de los potenciales evocados miogénicos vestibulares (VEMPs)

José Ignacio BENITO-OREJAS

Resumen


Introducción y objetivo: A principios de los años 90, Colebath y Halmagyi demuestran que es posible medir el potencial miogénico evocado del músculo esternocleidomastoideo a partir de una estimulación acústica o vibratoria del laberinto, dando nombre a los que desde entonces denominamos «potenciales evocados miogénicos vestibulares» (VEMPs: Vestibular-Evoked-Myogenic-Potentials). El objetivo de esta revisión consistirá en exponer las bases anatomofuncionales de los VEMPs y describir sus aplicaciones clínicas actuales. Método: Se trata de un trabajo descriptivo donde, a partir de la bibliografía que consideramos más destacada, se resumen las características, procedimientos de obtención y utilidad clínica de los VEMPs. Resultados y conclusiones: Mediante el registro de VEMPs oculares (oVEMPs) y cervicales (cVEMPs), podemos obtener de forma práctica, información clínica sobre las funciones utricular y sacular. Ambos procedimientos son específicos, sencillos, rápidos, reproducibles y seguros. Cuando estos resultados se combinan con otras pruebas vestibulares, se consigue llegar a tener un conocimiento funcional de cada uno de los receptores sensoriales del laberinto.

Palabras clave


potenciales evocados miogénicos vestibulares; sáculo y utrículo; membrana otolítica; sonido; vibración; enfermedades del laberinto.

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Referencias


Akin FW, Murnane OD: Vestibular Evoked Myogenic Potentials. En: Jacobson GP, Shepard NT: Balance function assessment and management. Plural Publishing, Inc. 1ª Ed. 2008. Cap. 18; pp. 405-434.

Alpini D, Pugnetti L, Caputo D, Cesarani A. Vestibular evoked myogenic potentials in multiple sclerosis: a comparison between onset and definite cases. Int Tinnitus J. 2005;11(1):48-51. PMid:16419689

Bath AP, Harris N, McEwan J, Yardley MP. Effect of conductive hearing loss on the vestibulo-collic reflex. Clin Otolaryngol Allied Sci. 1999;24(3):181-3. http://dx.doi.org/10.1046/j.1365-2273.1999.00234.x PMid:10384842

Brantberg K, Verrecchia L. Testing vestibular-evoked myogenic potentials with 90-dB clicks is effective in the diagnosis of superior canal dehiscence syndrome. Audiol Neurootol. 2009;14(1):54-8. http://dx.doi.org/10.1159/000153435 PMid:18781064

Chihara Y, Iwasaki S, Ushio M, Fujimoto C, Kashio A, Kondo K, et al. Ocular vestibular-evoked myogenic potentials (oVEMPs) require extraocular muscles but not facial or cochlear nerve activity. Clin Neurophysiol. 2009;120(3):581-7. http://dx.doi.org/10.1016/j.clinph.2008.12.030 PMid:19211302

Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology. 1992;42:1635-6. http://dx.doi.org/10.1212/WNL.42.8.1635

Colebatch JG, Rothwell JC. Motor unit excitability changes mediating vestibulocollic reflexes in the sternocleidomastoid muscle. Clin Neurophysiol. 2004;115(11):2567-73. http://dx.doi.org/10.1016/j.clinph.2004.06.012 PMid:15465446

Curthoys IS, Haslwanter T, Black RA, Burgess AM, Halmagyi GM, Topple AN, et al. Off-center yaw rotation: effect of naso-occipital linear acceleration on the nystagmus response of normal human subjects and patients after unilateral vestibular loss. Exp Brain Res. 1998;123(4):425-38. http://dx.doi.org/10.1007/s002210050587 PMid:9870602

Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol. 2013;33(3):231-7. http://dx.doi.org/10.1055/s-0033-1354595 PMid:24057826

Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol. 2013;33(3):231-7. http://dx.doi.org/10.1055/s-0033-1354595 PMid:24057826

Curthoys IS. A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound, vibration and galvanic stimuli. Clin Neurophysiol. 2010;121(2):132-44. http://dx.doi.org/10.1016/j.clinph.2009.09.027 PMid:19897412

Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope. 2012;122(6):1342-52. http://dx.doi.org/10.1002/lary.23258 PMid:22460150

Fujimoto C, Egami N, Kinoshita M, Sugasawa K, Yamasoba T, Iwasaki S. Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo: an analysis using oVEMP and cVEMP testing. Clin Neurophysiol. 2015;126(5):1033-8. http://dx.doi.org/10.1016/j.clinph.2014.07.028 PMid:25200460

Goldberg JM. Afferent diversity and the organization of central vestibular pathways. Exp Brain Res. 2000;130(3):277-97. http://dx.doi.org/10.1007/s002210050033 PMid:10706428 PMCid:PMC3731078

Halmagyi GM, Curthoys IS: Clinical anatomy and physiology of the vestibular system. En: Bronstein AM: Vertigo and Imbalance. Oxford University Press. 1ª Ed. 2013. Cap. 8; pp. 79-91. http://dx.doi.org/10.1093/med/9780199608997.003.0008

Halmagyi GM, Curthoys IS: Otolith function tests. En: Herdmann SJ, Clendaniel RA: Vestibular Rehabilitation. F.A. Davis Company. 4ª Ed. 2014. Cap. 12; pp. 195-226.

Halmagyi GM, Gresty MA, Gibson WP. Ocular tilt reaction with peripheral vestibular lesion. Ann Neurol. 1979;6(1):80-3. http://dx.doi.org/10.1002/ana.410060122 PMid:315752

Helling K, Schönfeld U, Clarke AH. Treatment of Ménière's disease by low-dosage intratympanic gentamicin application: effect on otolith function. Laryngoscope. 2007;117(12):2244-50. http://dx.doi.org/10.1097/MLG.0b013e3181453a3c PMid:17909448

Hong SM, Byun JY, Park CH, Lee JH, Park MS, Cha CI. Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo. Otolaryngol Head Neck Surg. 2008;139(4):541-5. http://dx.doi.org/10.1016/j.otohns.2008.07.003 PMid:18922341

Huang CH, Young YH. Ocular and cervical vestibular-evoked myogenic potentials in Tumarkin falls. Otol Neurotol. 2012;33(7):1251-6. http://dx.doi.org/10.1097/MAO.0b013e31826352e8 PMid:22858713

Iwasaki S, Fujimoto C, Kinoshita M, Kamogashira T, Egami N, Yamasoba T. Clinical characteristics of patients with abnormal ocular/cervical vestibular evoked myogenic potentials in the presence of normal caloric responses. Ann Otol Rhinol Laryngol. 2015;124(6):458-65. http://dx.doi.org/10.1177/0003489414564997 PMid:25533509

Iwasaki S, Smulders YE, Burgess AM, McGarvie LA, Macdougall HG, Halmagyi GM, et al. Ocular vestibular evoked myogenic potentials in response to bone-conducted vibration of the midline forehead at Fz. A new indicator of unilateral otolithic loss. Audiol Neurootol. 2008;13(6):396-404. http://dx.doi.org/10.1159/000148203 PMid:18663292

Janky KL, Nguyen KD, Welgampola M, Zuniga MG, Carey JP. Air-conducted oVEMPs provide the best separation between intact and superior canal dehiscent labyrinths. Otol Neurotol. 2013;34(1):127-34. http://dx.doi.org/10.1097/MAO.0b013e318271c32a PMid:23151775 PMCid:PMC3621128

Kantner C, Gürkov R. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials. Hear Res. 2012;294(1-2):55-63. http://dx.doi.org/10.1016/j.heares.2012.10.008 PMid:23123220

Krause E, Wechtenbruch J, Rader T, Gürkov R. Influence of cochlear implantation on sacculus function. Otolaryngol Head Neck Surg. 2009;140(1):108-113. http://dx.doi.org/10.1016/j.otohns.2008.10.008 PMid:19130972

Kushiro K, Zakir M, Ogawa Y, Sato H, Uchino Y. Saccular and utricular inputs to sternocleidomastoid motoneurons of decerebrate cats. Exp Brain Res. 1999;126(3):410-6. http://dx.doi.org/10.1007/s002210050747 PMid:10382625

Kushiro K, Zakir M, Sato H, Ono S, Ogawa Y, Meng H, et al. Saccular and utricular inputs to single vestibular neurons in cats. Exp Brain Res. 2000;13:406-15. http://dx.doi.org/10.1007/s002219900312

Lee KJ, Kim MS, Son EJ, Lim HJ, Bang JH, Kang JG. The Usefulness of Rectified VEMP. Clin Exp Otorhinolaryngol. 2008;1(3):143-7. http://dx.doi.org/10.3342/ceo.2008.1.3.143 PMid:19434246 PMCid:PMC2671751

Li MW, Houlden D, Tomlinson RD. Click evoked EMG responses in sternocleidomastoid muscles: characteristics in normal subjects. J Vestib Res. 1999;9(5):327-34. PMid:10544371

Magliulo G, Gagliardi S, Ciniglio Appiani M, Iannella G, Re M. Vestibular neurolabyrinthitis: a follow-up study with cervical and ocular vestibular evoked myogenic potentials and the video head impulse test. Ann Otol Rhinol Laryngol. 2014;123(3):162-73. http://dx.doi.org/10.1177/0003489414522974 PMid:24633942

Manzari L, Burgess AM, Curthoys IS. Does unilateral utricular dysfunction cause horizontal spontaneous nystagmus?. Eur Arch Otorhinolaryngol. 2012;269(11):2441-5. http://dx.doi.org/10.1007/s00405-012-2127-z PMid:22869020

Manzari L, Burgess AM, Curthoys IS. Ocular and cervical vestibular evoked myogenic potentials in response to bone-conducted vibration in patients with probable inferior vestibular neuritis. J Laryngol Otol. 2012;126(7):683-91. http://dx.doi.org/10.1017/S0022215112000692 PMid:22583739

Manzari L, Burgess AM, McGarvie LA, Curthoys IS. An indicator of probable semicircular canal dehiscence: ocular vestibular evoked myogenic potentials to high frequencies. Otolaryngol Head Neck Surg. 2013;149(1):142-5. http://dx.doi.org/10.1177/0194599813489494 PMid:23674567

Manzari L, Tedesco A, Burgess AM, Curthoys IS. Ocular vestibular-evoked myogenic potentials to bone-conducted vibration in superior vestibular neuritis show utricular function. Otolaryngol Head Neck Surg. 2010;143(2):274-80. http://dx.doi.org/10.1016/j.otohns.2010.03.020 PMid:20647134

Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope. 2005;115(10):1717-27. http://dx.doi.org/10.1097/01.mlg.0000178324.55729.b7 PMid:16222184

Murofushi T, Iwasaki S, Ushio M. Recovery of vestibular evoked myogenic potentials after a vertigo attack due to vestibular neuritis. Acta Otolaryngol. 2006;126(4):364-7. http://dx.doi.org/10.1080/00016480500417189 PMid:16608787

Murofushi T, Komiyama S, Yoshimura E. Do patients who experience episodic tilting or translational sensations in the pitch plane have abnormal sacculo-collic reflexes?. Neurosci Lett. 2013 Oct 11;553:95-8. http://dx.doi.org/10.1016/j.neulet.2013.08.002 PMid:23973336

Murofushi T, Nakahara H, Yoshimura E, Tsuda Y. Association of air-conducted sound oVEMP findings with cVEMP and caloric test findings in patients with unilateral peripheral vestibular disorders. Acta Otolaryngol. 2011;131(9):945-50. http://dx.doi.org/10.3109/00016489.2011.580003 PMid:21563874

Node M, Seo T, Miyamoto A, Adachi A, Hashimoto M, Sakagami M. Frequency dynamics shift of vestibular evoked myogenic potentials in patients with endolymphatic hydrops. Otol Neurotol. 2005;26(6):1208-13. http://dx.doi.org/10.1097/01.mao.0000176172.87141.5d PMid:16272944

Okuno T, Sando I. Localization, frequency, and severity of endolymphatic hydrops and the pathology of the labyrinthine membrane in Menière's disease. Ann Otol Rhinol Laryngol. 1987;96(4):438-45. http://dx.doi.org/10.1177/000348948709600418 PMid:3619290

Papathanasiou ES, Murofushi T, Akin FW, Colebatch JG. International guidelines for the clinical application of cervical vestibular evoked myogenic potentials: an expert consensus report. Clin Neurophysiol. 2014;125(4):658-66. http://dx.doi.org/10.1016/j.clinph.2013.11.042 PMid:24513390

Patko T, Vidal PP, Vibert N, Tran Ba Huy P, de Waele C. Vestibular evoked myogenic potentials in patients suffering from an unilateral acoustic neuroma: a study of 170 patients. Clin Neurophysiol. 2003;114(7):1344-50. http://dx.doi.org/10.1016/S1388-2457(03)00119-6

Pérez-Fernández N, Cervera-Paz FJ: Otras exploraciones del sistema vestibular. En: Bartual-Pastor J, Pérez-Fernández N: El sistema vestibular y sus alteraciones. Tomo I: Fundamentos y Semiología. Masson, S.A. 1ª Ed. 1998. Cap 15; pp. 239-255.

Rosengren SM, Govender S, Colebatch JG. Ocular and cervical vestibular evoked myogenic potentials produced by air- and bone-conducted stimuli: comparative properties and effects of age. Clin Neurophysiol. 2011;122(11):2282-9. http://dx.doi.org/10.1016/j.clinph.2011.04.001 PMid:21550301

Rosengren SM, McAngus Todd NP, Colebatch JG. Vestibular-evoked extraocular potentials produced by stimulation with bone-conducted sound. Clin Neurophysiol. 2005;116(8):1938-48. http://dx.doi.org/10.1016/j.clinph.2005.03.019 PMid:15979939

Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol. 2010;121(5):636-51. http://dx.doi.org/10.1016/j.clinph.2009.10.016 PMid:20080441

Sauvage, JP. Vertiges: manuel de diagnostic et de réhabilitation. Elsevier Masson SAS. 1ª Ed. 2010. Cap. 4; pp. 23-32.

Sheykholeslami K, Murofushi T, Kaga K. The effect of sternocleidomastoid electrode location on vestibular evoked myogenic potential. Auris Nasus Larynx. 200;28(1):41-3.

Sheykholeslami K, Murofushi T, Kermany MH, Kaga K. Bone-conducted evoked myogenic potentials from the sternocleidomastoid muscle. Acta Otolaryngol. 2000;120(6):731-4. http://dx.doi.org/10.1080/000164800750000252 PMid:11099149

Shin BS, Oh SY, Kim JS, Kim TW, Seo MW, Lee H, Park YA. Cervical and ocular vestibular-evoked myogenic potentials in acute vestibular neuritis. Clin Neurophysiol. 2012 Feb;123(2):369-75. http://dx.doi.org/10.1016/j.clinph.2011.05.029 PMid:21775203

Su CH, Young YH. Differentiating cerebellar and brainstem lesions with ocular vestibular-evoked myogenic potential test. Eur Arch Otorhinolaryngol. 2011;268(6):923-30. http://dx.doi.org/10.1007/s00405-010-1463-0 PMid:21170655

Taylor RL, Bradshaw AP, Halmagyi GM, Welgampola MS. Tuning characteristics of ocular and cervical vestibular evoked myogenic potentials in intact and dehiscent ears. Audiol Neurootol. 2012;17(4):207-18. http://dx.doi.org/10.1159/000336959 PMid:22472299

Todd NP, Rosengren SM, Aw ST, Colebatch JG. Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol. 2007;118(2):381-90. http://dx.doi.org/10.1016/j.clinph.2006.09.025 PMid:17141563

Tseng CC, Wang SJ, Young YH. Comparison of bone-conducted vibration for eliciting ocular vestibular-evoked myogenic potentials: forehead versus mastoid tapping. Otolaryngol Head Neck Surg. 2012;146(2):289-94. http://dx.doi.org/10.1177/0194599811425884 PMid:22020789

Uchino Y, Sasaki M, Sato H, Imagawa M, Suwa H, Isu N. Utriculoocular reflex arc of the cat. J Neurophysiol. 1996;76:1896-903. PMid:8890302

Uchino Y, Sato H, Sasaki M, Imagawa M, Ikegami H, Isu N, et al. Sacculocollic reflex arcs in cats. J Neurophysiol. 1997;77:3003-12. PMid:9212252

Ward BK, Wenzel A, Ritzl EK, Gutierrez-Hernandez S, Della Santina CC, Minor LB, et al. Near-dehiscence: clinical findings in patients with thin bone over the superior semicircular canal. Otol Neurotol. 2013;34(8):1421-8. http://dx.doi.org/10.1097/MAO.0b013e318287efe6 PMid:23644303 PMCid:PMC3740012

Weber KP, Rosengren SM. Clinical utility of ocular vestibular-evoked myogenic potentials (oVEMPs). Curr Neurol Neurosci Rep. 2015;15(5):22. http://dx.doi.org/10.1007/s11910-015-0548-y PMid:25773001

Welgampola MS, Colebatch JG. Characteristics of tone burst-evoked myogenic potentials in the sternocleidomastoid muscles. Otol Neurotol. 2001;22(6):796-802. http://dx.doi.org/10.1097/00129492-200111000-00014

Welgampola MS, Colebatch JG. Vestibulocollic reflexes: normal values and the effect of age. Clin Neurophysiol. 2001;112(11):1971-9. http://dx.doi.org/10.1016/S1388-2457(01)00645-9

Welgampola MS, Colebatch JG. Vestibulospinal reflexes: quantitative effects of sensory feedback and postural task. Exp Brain Res. 2001;139(3):345-53. http://dx.doi.org/10.1007/s002210100754

Winters SM, Berg IT, Grolman W, Klis SF. Ocular vestibular evoked myogenic potentials: frequency tuning to air-conducted acoustic stimuli in healthy subjects and Ménière's disease. Audiol Neurootol. 2012;17(1):12-9. http://dx.doi.org/10.1159/000324858 PMid:21540585

Young YH, Wu CC, Wu CH. Augmentation of vestibular evoked myogenic potentials: an indication for distended saccular hydrops. Laryngoscope. 2002;112(3):509-12. http://dx.doi.org/10.1097/00005537-200203000-00019 PMid:12148863




DOI: http://dx.doi.org/10.14201/orl201674.14643

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