Utilidad clínica de los potenciales evocados miogénicos vestibulares (VEMPs)
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.
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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
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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
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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
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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
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