Delayed vestibular evoked responses to the eyes and neck in a patient with an isolated brainstem lesion.

Clin Neurophysiol

UNSW Clinical School and Prince of Wales Medical Research Institute, Institute of Neurological Sciences, High Street, Randwick, Sydney, NSW 2031, Australia.

Published: September 2007

AI Article Synopsis

  • The study investigated two tests, VEMPs and OVEMPs, to assess the vestibular system and identify lesions in the brainstem.
  • Results showed delayed responses in the left side for both types of tests, indicating a possible issue related to demyelination.
  • The findings suggest that these tests can help localize and understand the characteristics of vestibular pathway lesions.

Article Abstract

Objective: Two recently described tests of the vestibular system, vestibular evoked myogenic potentials (VEMPs) and ocular vestibular evoked myogenic potentials (OVEMPs), test the descending and ascending vestibular brainstem pathways, respectively. We describe a case of a patient in whom these investigations localised the lesion and suggested its nature.

Methods: VEMPs (to clicks and short duration galvanic stimulation) and OVEMPs (to clicks) were recorded.

Results: Click- and galvanic-evoked VEMPs were delayed on the left side (by approximately 5-6 ms), and click-evoked OVEMPs were similarly delayed (by approximately 4 ms) following left-sided stimulation. Repeat testing 21 months later showed partial resolution.

Conclusions: The observed delays in evoked potentials suggested a demyelinating lesion. Furthermore, the similarity in delayed responses to neck and extraocular muscles was suggestive of a lesion at the root entry zone of the vestibulocochlear nerve.

Significance: VEMPs and OVEMPS may thus provide information about the location and nature of lesions affecting central vestibular pathways.

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Source
http://dx.doi.org/10.1016/j.clinph.2007.05.068DOI Listing

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