Brainstem lesion in benign paroxysmal vertigo children: Evaluated by a combined ocular and cervical vestibular-evoked myogenic potential test
Journal
International Journal of Pediatric Otorhinolaryngology
Journal Volume
74
Journal Issue
5
Pages
523
Date Issued
2010-05-01
Author(s)
Abstract
Objective: This study utilized a combined ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) test in children with benign paroxysmal vertigo (BPV) to investigate whether the upper or lower brainstem is more frequently affected in BPV children. Methods: Fifteen BPV children aged 4-14 years, and 15 age- and sex-matched healthy children were enrolled. All subjects underwent pure tone audiometry, stabilometry, and a combined oVEMP and cVEMP test using acoustic stimulation. Results: All BPV patients displayed normal hearing and clear oVEMPs. However, 11 (73%) of 15 BPV patients had delayed cVEMPs, showing significant difference when compared with 100% normal cVEMPs in healthy children. The sway path and sway area in stabilometry were significantly different between BPV and healthy children, regardless of whether their eyes were open or closed. However, neither the sway path nor sway area correlated significantly with cVEMP results. Conclusion: Normal oVEMPs in BPV children indicate an intact vestibulo-ocular reflex pathway, which travels through the upper brainstem. In contrast, delayed cVEMPs in BPV children reflect a retrolabyrinthine lesion along the sacculo-collic reflex pathway, which descends via the lower brainstem. Hence, the lower brainstem is more frequently affected than the upper brainstem in children with BPV. © 2010 Elsevier Ireland Ltd.
Subjects
Benign paroxysmal vertigo | Cervical vestibular-evoked myogenic potential (cVEMP) | Migraine equivalent | Ocular vestibular-evoked myogenic potential (oVEMP) | Stabilometry
SDGs
Publisher
ELSEVIER IRELAND LTD
Type
journal article