Vestibulär evozierte Potenziale – Untersuchungstechnik und klinische Bedeutung

Zusammenfassung

Die vestibulär evozierten Potenziale prüfen die Integrität eines Reflexes, der aus dem Sacculus als Rezeptor, dem Nc. vestibularis sowie Halsmuskeln als Effektoren besteht. Dieser Reflex ist bei verschieden Erkrankungen, die besonders die vestibulären Rezeptoren betreffen, pathologisch verändert. Er kann als klinischer Routinetest mit Geräten durchgeführt werden, die zur Untersuchung der akustisch evozierten Hirnstammpotenziale geeignet sind. In dieser Übersicht werden die Untersuchungstechnik und klinische Anwendungen vorgestellt.

Abstract

Vestibular evoked potentials can be investigated to test the integrity of a reflex which involves peripheral vestibular receptors (mainly the sacculus), the vestibular nucleus and the neck muscles. This test is easy to apply and will result in pathological findings in several diseases with involvement of the vestibular organs. Here, the technique for investigating this reflex is presented as well as its clinical applications.

Schlüsselwörter

vestibulär evozierten Potenziale - Untersuchungstechnik - klinische Anwendungen - Sacculus - Nc. vestibularis - Halsmuskeln

Key words

vestibular evoked potential - invexstigation method - clinical applications - sacculus - vestibular nucleus - neck muscles

Literatur

• 1 Bötzel K, Feise P, Kolev OI. et al . Postural reflexes evoked by tapping forehead and chest.  Exp Brain Res. 2001;  138 446-451
• 2 Todd N, Cody FWJ, Banks JR. A saccular origin of frequency tuning in myogenic vestibular evoked potentials? implications for human responses to loud sounds.  Hear Res. 2000;  141 180-188
• 3 Murofushi T, Matsuzaki M, Wu CH. Short tone burst-evoked myogenic potentials on the sternocleidomastoid muscle: are these potentials also of vestibular origin?.  Arch Otolaryngol Head Neck Surg. 1999;  125 660-664
• 4 Halmagyi GM, Yavor RA, Colebatch JG. Tapping the head activates the vestibular system: A new use for the clinical reflex hammer.  Neurology. 1995;  45 1927-1929
• 5 Welgampola MS, Rosengren SM, Halmagyi GM. et al . Vestibular activation by bone conducted sound.  J Neurol Neurosurg Psychiatry. 2003;  74 771-778
• 6 Watson SRD, Fagan P, Colebatch JG. Galvanic stimulation evokes short-latency EMG responses in sternocleidomastoid which are abolished by selective vestibular nerve section.  Electroenceph Clin Neurophysiol Electromyogr Mot Contol. 1998;  109 471-474
• 7 Murofushi T, Takegoshi H, Ohki M. et al . Galvanic-evoked myogenic responses in patients with an absence of click-evoked vestibulo-collic reflexes.  Clin Neurophysiol. 2002;  113 305-309
• 8 Fujimoto C, Iwasaki S, Matsuzaki M. et al . Lesion site in idiopathic bilateral vestibulopathy: a galvanic vestibular-evoked myogenic potential study.  Acta Otolaryngol. 2005;  125 430-432
• 9 Welgampola MS, Colebatch JG. Vestibulocollic reflexes: normal values and the effect of age.  Clin Neurophysiol. 2001;  112 1971-1979
• 10 Brantberg K, Granath K, Schart N. Age-related changes in vestibular evoked myogenic potentials.  Audiol Neurootol. 2007;  12 247-253
• 11 Young YH, Huang TW, Cheng PW. Assessing the stage of Meniere's disease using vestibular evoked myogenic potentials.  Arch Otolaryngol Head Neck Surg. 2003;  129 815-818
• 12 Lin MY, Timmer FC, Oriel BS. et al . Vestibular evoked myogenic potentials (VEMP) can detect asymptomatic saccular hydrops.  Laryngoscope. 2006;  116 987-992
• 13 Timmer FC, Zhou G, Guinan JJ. et al . Vestibular evoked myogenic potential (VEMP) in patients with Meniere's disease with drop attacks.  Laryngoscope. 2006;  116 776-779
• 14 Wagner JN, Glaser M, Brandt T. et al . Downbeat nystagmus: Aetiology and comorbidity in 117 patients.  J Neurol Neurosurg Psychiatry. 2007; 
• 15 Halmagyi GM, Curthoys IS. A clinical sign of canal paresis.  Arch Neurol. 1988;  45 737-739
• 16 Zingler VC, Weintz E, Jahn K. et al . Saccular function less affected than canal function in bilateral vestibulopathy.  J Neurol. 2008;  255 1332-1336
• 17 Murofushi T, Halmagyi GM, Yavor RA. et al . Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis.  An indicator of inferior vestibular nerve involvement? Arch Otolaryngol Head Neck Surg. 1996;  122 845-848
• 18 Ochi K, Ohashi T, Watanabe S. Vestibular-evoked myogenic potential in patients with unilateral vestibular neuritis: abnormal VEMP and its recovery.  J Laryngol Otol. 2003;  117 104-108
• 19 Patko T, Vidal PP, Vibert N. et al . Vestibular evoked myogenic potentials in patients suffering from an unilateral acoustic neuroma: a study of 170 patients.  Clin Neurophysiol. 2003;  114 1344-1350
• 20 Iwasaki S, Smulders YE, Burgess AM. et al . Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects.  Clin Neurophysiol. 2008;  119 2135-2147
• 21 Todd NP, Rosengren SM, Colebatch JG. Ocular vestibular evoked myogenic potentials (OVEMPs) produced by impulsive transmastoid accelerations.  Clin Neurophysiol. 2008;  119 1638-1651

1 Amplitudenratio: AR (%)=100×(A_l – A_s)/(A_l + A_s); wobei A_l : größere Amplitude, A_s: kleinere Amplitude

Korrespondenzadresse