Vestibular evoked myogenic potential and electrocochleography in patients with benign paroxysmal positional vertigo
DOI:
https://doi.org/10.33233/fb.v24i3.5304Keywords:
vertigo, benign paroxysmal positional vertigo, labyrinth diseases, vestibular evoked myogenic potentials, evoked response audiometryAbstract
Introduction: Benign Paroxysmal Positional Vertigo is considered the most frequent cause of vertigo attributed to vestibular dysfunction. Vestibular Evoked Myogenic Potential and Electrocochleography are complementary exams of otoneurological evaluation that present several characteristics favorable to its use, as they evaluate specific structures of the vestibular system, until then not evaluated by traditional vestibular exams performed in clinical practice. Objectives: To analyze and associate the responses of Cervical Vestibular Evoked Myogenic Potential and Electrocochleography in patients diagnosed with Benign Paraxysmal Positional Vertigo. Methods: Cross-sectional study with a diagnostic intervention using pure tone audiometry, acoustic immittance measures, Cervical Vestibular Evoked Myogenic Potential, and Electrocochleography, which evaluated 23 individuals with a medical diagnosis of Benign Paroxysmal Positional Vertigo. Results: In the Cervical Vestibular Evoked Myogenic Potential procedure, the mean latencies of P13 and N23 were 16.9ms and 23.7ms in right ear, and 17.0ms and 24.0ms in left ear, respectively. The average asymmetry index was 19.3%. In the Electrocochleography test, 21 (91.30%) individuals showed changes. Conclusion: In the association of Electrocochleography with Benign Paroxysmal Positional Vertigo, the results showed statistical relevance, differently from the results of Cervical Vestibular Evoked Myogenic Potential associated with Benign Paroxysmal Positional Vertigo. However, changes in the findings of Cervical Vestibular Evoked Myogenic Potential were found in individual and qualitative analyzes.
References
Guerraz M, Day BL. Expectation and the vestibular control of balance. J Cogn Neurosci. 2005;17(3):463-9. doi: 10.1162/0898929053279540
Hain TC, Ramaswamy TS, Hillman MA. Anatomia e fisiologia do sistema vestibular normal. In: Herdman SJ. Reabilitação vestibular. 2ª ed. São Paulo: Manole; 2002.
Ganança MM, Vieira RM, Caovilla HH. Princípios de otoneurologia. Vol. 1. São Paulo: Atheneu; 1999.
Bohlsen YB, Torres MLB. Interpretanto a eletronistagmografia e a vecto-eletronistagmografia na avaliação vestibular. In: Gama MR (Org.). Resolvendo casos em audiologia. São Paulo: Summus; 2001. p.99-132.
Ruwer SL. Estudo da posturografia dinâmica - "Foam-Laser" em indivíduos normais com idades entre 14 e 60 anos [Dissertação]. Santa Maria, RS: Universidade Federal de Santa Maria; 2006.
Connor SE, Sriskandan N. Imaging of dizziness. Clin Radiol. 2014;69:111-22. doi: 10.1016/j.crad.2013.10.013
Helminski JO, Janssen I, Hain TC. Daily exercise does not prevent recurrence of benign paroxysmal positional vertigo. Otol Neurotol. 2008; 29(7):976-81. doi: 10.1097/MAO.0b013e318184586d
Von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res. 2015;25 (3-4):105-17. doi:10.3233/VES-150553
Fetter M. Vestibular System Disorders. In: Herdman SJ, ed. Vestibular Rehabilitation. Philadelphia: Davis; 1994. p. 80-9.
Brandt T. Vertigo: Its multisensory syndromes. London: Springer; 1991. 329p.
Ganança MM, Caovilla HH, Munhoz MSL, Silva MLG, Ganança FF, Ganança CF. Lidando com a vertigem posicional paroxística benigna. Acta Orl. [Internet]. 2005 [citado 2022 Oct 12];23(1):18-25. Disponível em: https://www.researchgate.net/publication/237402346_Lidando_com_a_Vertigem_Posicional_Paroxistica_Benigna
Von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of Benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78:710-5. doi: 10.1136/jnnp.2006.100420
Neuhauser HK. Epidemiology of vertigo. Curr Opin Neurol. 2007; 20(1):40-6. doi: 10.1097/WCO.0b013e328013f432
Aguiar AI, Silva RM, Bittencourt J, Silva ALM, Machado D, Teixeira SS, et al. Aspectos clínicos e terapêuticos da Vertigem Postural Paroxística Benigna (VPPB): um estudo de revisão. Ciência em Movimento [Internet]. 2010 [citado 2022 Oct 20];12(23). https://www.metodista.br/revistas/revistas-ipa/index.php/RS/article/viewFile/96/60
Sauvage JP, Grenier H. Reabilitação vestibular - guia prático. 1ª ed. Rio de Janeiro: Revinter; 2017.
Maranhão-Filho P, Maranhão ET. Vertigem posicional paroxística benigna & reflexos vestibulares: testes e manobras à beira do leito. 1 ed. Rio de Janeiro: Revinter; 2017.
Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ, Cass S, et al. Clinical practice guideline: benign paroxysmal positional vertigo. Arch Otolaryngol. 2008;139(5 Suppl 4):47-81. doi: 10.1016/j.otohns.2008.08.022
Ganança MM, Caovilla HH, Munhoz MSL, Silva MLG, Ganança FF, Ganança CF. Vertigem posicional paroxística benigna. Rev Bras Med Otorrinolaringol. 2000;7:66-72.
Hall SF, Ruby RR, McClure JA. The mechanics of benign paroxysmal vertigo. J Otolaryngol. [Internet]. 1979 [citado 2022 Oct 10];8(2):151-8. Disponível em: https://pubmed.ncbi.nlm.nih.gov/430582/
Lopez-Escamez JA, Molina MI, Gamiz M, Fernandez-Perez AJ, Gómes M, Palma MJ, et al. Multiple positional nystagmus suggests multiple canal involvement in benign paroxysmal positional vertigo. Acta Otolaryngol. 2005;125(9):954-61. doi: 10.1080/00016480510040146
Dix MR, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Lond. [Internet]. 1952[cited 2022 Oct 10];45(6):341-51. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1987487/
Schuknecht HF. Pathology of the ear. Cambridge: Harvard University Press; 1974.
Oliveira AC. Potenciais evocados na avaliação vestibular. In: Bevilacqua MC, Martinez MAN, Balen SA, et al. Tratado de audiologia. São Paulo: Santos; 2011. p. 331-345.
Oliveira AC. Potenciais evocados cervical e ocular na avaliação vestibular. In: Boéchat EM, Menezes PL, Couto CM, et al. Tratado de audiologia. 2ª ed. Rio de Janeiro: Guanabara Koogan; 2015. p. 193-8.
Cal R, Jr FB. Potencial evocado miogênico vestibular: uma visão geral. Braz J Otorhinolaryngol. 2009;75(3):456-62. doi:10.1590/S1808-86942009000300023
Colebatch JG, Halmagyi GM, Skuse NF. Myogenic potentials generated by a click-evoked vestibulocolic reflex. J Neurol Neurosurg Psychiatry 1994:57(2):190-97. doi: 10.1136/jnnp.57.2.190
Cal R, Maia FCZ, Araújo MS, Brusco TR. In: Maia FCZ, Albernaz PLM, Carmona S. Otoneurologia atual. 1ª ed. Rio de Janeiro: Revinter; 2014. p. 275-317.
Sousa LCA, Zamberlan-Amorin NE, Braga DO. Avaliação eletrofisiológica da audição: eletrococleografia, potenciais evocados auditivos de tronco encefálico, resposta auditiva de estado estável e P300. In: Tratado de otorrinolaringologia / organização Shirley Shizue Nagata Pignatari, Wilma Terezinha Anselmo-Lima. 3. ed. Rio de Janeiro: Elsevier; 2008.
Sousa LCA, Piza MRT, Alvarenga KF, Cóser PL. Eletrofisiologia da audição e emissões otoacústicas: princípios e aplicações clínicas. 2.ed. Ribeirão Preto: Novo Conceito; 2010.
Anastasio ART. Eletrococleografia. In: Bevilacqua MC, Martinez MAN, Balen SA, et al. Tratado de audiologia. São Paulo: Santos, 2011. p. 159-180.
Anastasio ART, Hyppolito MA. Eletrococleografia. In: Boéchat EM, Menezes PL, Couto CM, et al. Tratado de audiologia. 2ª ed. Rio de Janeiro: Guanabara Koogan; 2015. p. 100-10.
Lloyd LL, Kaplan H. Audiometric interpretation: a manual of basic audiometry. University Park Press: Baltimore; 1978. p.16.
Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24. doi: 10.1001/archotol.1970.04310040005002
Jerger J, Jerger S, Mauldin L. Studies in impedance audiometry. Normal and sensorineural ears. Arch Otolaringol. 1972;96;513-23. doi: 10.1001/archotol.1972.00770090791004
Nedzelski JM, Barber HO, McIlmoyl L. Diagnoses in a dizziness unit. J Otolaryngol 1986;15:101-4. https://pubmed.ncbi.nlm.nih.gov/3712537/
Dorigueto RS, Mazzetti KR, Gabilan YPL, Ganança FF. Benign paroxysmal positional vertigo recurrence and persistence. Braz J Otorhinolaryngol. 2009;75(4):565-72. doi:10.1590/S1808-86942009000400016
Caldas MA, Ganança CF, Ganança FF, Ganança MM, Caovilla HH. Vertigem posicional paroxística benigna: caracterização clínica. Braz J Otorhinolaryngol. 2009;76(4):760-4. doi: 10.1590/S1808-86942009000400006
Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertio (BPPV). CMAJ. 2003;169(7):681-93.
Kuhn AMB, Dorigueto RS, Ganança MM, Caovilla HH, Ganança FF, Gazzola JM, et al. Follow up study in BPPV patients: emotional aspects. In: 31º Annual Meeting of the International Neuro-otologic and Equilibriometric Society; 2004; Proceedings. Bad Kissingen, German. Bad Kissingen: AMNO; 2004.
Weider DJ, Ryder CJ, Stram JR. Benign paroxysmal positional vertigo: analysis of 44 cases treated by the canalith repositioning procedure of Epley. Am J Otol. 1994;15(3):321-6.
Lobo JS, Boyev KP, Manokey BJ, Mattox DE. Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo. Laryngoscope. 1999;109(6):900-3. doi: 10.1097/00005537-199906000-00011
Manobe H, Sugasawa K, Murofushi T. The outcome of the canalith repositioning procedure for benign paroxysmal positional vertigo: are there any characteristic features of treatment failure cases? Acta Otolaryngol Suppl. 2001;545:38-40. doi:10.1080/000164801750388081
Munaro G, Silveira AF. Avaliação vestibular na vertigem posicional paroxística benigna típica e atípica. Rev Cefac. 2009;11(supl1):76-84. doi: 10.1590/S1516-18462009000500012
Silva PAB. Do equilíbrio em pacientes com vertigem posicional paroxística benigna [dissertação]. Santa Maria, RS: Universidade Federal de Santa Maria; 2011.
Lira-Batista MMS, Dorigueto RS, Ganança CF. Vestibular evoked myogenic potentials and digital vectoelectronystagmography’s study in patients with benign paroxysmal positional vertigo. Int Arch Otorhinolaryngol. 2013;17(2):147-156. doi: 10.7162/S1809-97772013000200006
Moreira MD, Costa VSP, Melo JJ, Marchiori LLM. Prevalência e associações da vertigem posicional paroxística benigna em idosos. Rev Cefac. 2014;16(5):1533-40. doi: 10.1590/1982-021620149513
Oliveira AKS, Suzuki FA, Boari L. Is it important to repeat the positioning maneuver after the treatment for benign paroxysmal positional vertigo? Braz J Otorhinolaryngol. 2015;81(2):197-201. doi: 10.1016/j.bjorl.2014.06.002
Guzmán PV, Zeigelboim BS, Hassan SEF, Diniz Junior J, Caovilla HH. A manobra de Brandt & Daroff modificada na reabilitação da vertigem postura. Acta AWHO. 2000;19(4):189-92.
André APR. Variantes da manobra de Epley no tratamento da vertigem postural paroxística benigna de canal posterior em idoso [Tese]. Ribeirão Preto (SP): Universidade de São Paulo; 2007.
Rodrigues DL. Eficácia da reabilitação vestibular no tratamento e espaçamento das crises em pacientes com VPPB [Dissertação]. Brasília, DF: Universidade de Brasília; 2017.
Von Brevern M, Seelig T, Neuhauser H, Lempert T. Benign paroxysmal positional vertigo predominantly affects the right labyrinth. J Neurol Neurosurg Psychiatry. 2004; 75:1487-8. doi: 10.1136/jnnp.2003.031500
Slater R. Benign positional vertigo. ENG Report. ICS Medical; 1985, April. p. 1-2.
Libonati GA. Vertigem posicional paroxística benigna. In: Maia FCZ, Albernaz PLM, Carmona S. Otoneurologia atual. 1ª ed. Rio de Janeiro: Revinter; 2014. pág. 275-317.
Dorigueto RS. Estudo do potencial evocado miogênico vestibular na vertigem posicional paroxística benigna [Tese]. São Paulo: Universidade Federal de São Paulo; 2010.
Su HC, Huang TW, Young YH, Cheng PW. Aging effect on vestibular evoked myogenic potential. Otol Neurotol. 2004;25(6):977-80. doi: 10.1097/00129492-200411000-00019
Hong SM, Yeo SG, Kim SW, Cha CI. The results of vestibular evoked myogenic potentials, with consideration of age-related changes, in vestibular neurits, benign paroxysmal positional vertigo, and Meniere's disease. Acta Otolaryngol. 2008; 128(8):861-5. doi: 10.1080/00016480701784981
Akkuzu G, Akkuzu B, Ozluoglu LN. Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere's disease. Eur Arch Otorhinolaryngol; 2006;263(6):510-7. doi: 10.1007/s00405-005-0002-x
Murifushi T. Vestibular evoked myogenic potential. World J Otorhinolaryngol. 2014;4(2):6-11. doi: 10.5319/wjo.v4.i2.6
Silva TR, Resende LM, Santos MAR. Potencial evocado miogênico vestibular ocular e cervical simultâneo em indivíduos normais. CoDAS 2016;28(1):34-40.
Silva BMP, Didoné DD, Sleifer P. Potencial evocado miogênico vestibular cervical em crianças e adolescentes sem queixas vestibulares. Audiol Commun. Res. 2017; 22:1885. doi:10.1590/2317-6431-2017-1885
Lamounier P, Souza TSA, Gobbo DA, Jr FB. Evaluation of vestibular evoked myogenic potentials (VEMP) and electrocochleography for the diagnosis of Ménière’s disease. Braz J Otorhinolaryngol. 2017;83(4):394-403. doi: 10.1016/j.bjorl.2016.04.021
Welgampola MS, Myrie OA, Minor LB, Carey JP. Vestibular-evoked myogenic potential thresholds normalize on plugging superior canal dehiscence. Neurology. 2008;70(6):464-72. doi: 10.1212/01.wnl.0000299084.76250.4a
Rey-Martínez J, Rama-López J, Pérez-Fernández N, Guzmán RBD. ¿Cómo analizar un potencial evocado miogénico vestibular? Aplicación de un método no lineal. Acta Otorrinolaringol. Esp. 2011;62(2):126-31.
Murofushi T, Halmagyi GM, Yavor RA, Colebatch JG. Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis: an indicator of inferior vestibular nerve involvement? Arch Otolaryngol Head Neck Surg. 1996:845-48. doi: 10.1001/archotol.1996.01890200035008
Murofushi T, Shimizu K, Takegoshi H, Cheng PW. Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol. 2001;127(9)1069-72. doi: 10.1001/archotol.127.9.1069
Paparella MM, Mancini F. Trauma and Ménière’s syndrome. Laryngoscope 1983;93(8):1004-12. doi: 10.1288/00005537-198308000-00006
Paparella MM. Pathogenesis of Meniere’s disease and Meniere’s syndrome. Acta Otolaryngol. 1984;406(Suppl):10-25. doi: 10.3109/00016488309122996
Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope. 1997; 107(5):607-13. doi: 10.1097/00005537-199705000-00010
Gross EM, Ress BD, Viirre ES, Nelson JR, Harris JF. Intractable benign paroxysmal positional vertigo in patients with Meniere‘s disease. Laryngoscope. 2000;110(4):655-9. doi: 10.1097/00005537-200004000-00022
Perez N, Martin E, Zubieta JL, Romero MD, Garcia-Tapia R. Benign paroxysmal positional vertigo in patients with Ménière’s disease treated with intratympanic gentamycin. Laryngoscope. 2002; 112(6):1104-9. doi: 10.1097/00005537-200206000-00031
Dornhoffer JL, Colvin GB. Benign paroxysmal positional vertigo and canalith repositioning: clinical correlations. Am J Otol. 2000; 21(2):230-3. doi: 10.1016/s0196-0709(00)80014-9
Karlberg M, Hall K, Quickert N, Hinson J, Halmagyi GM. What inner ear disease cause benign paroxysmal positional vertigo? Acta Otolaryngol. 2000;120(3):380-5. doi: 10.1080/000164800750000603
Ganança CF, Caovilla HH, Gazzola JM, Ganança MM, Ganança FF. Manobra de Epley na vertigem posicional paroxística benigna associada à doença de Ménière. Rev Bras Otorrinolaringol. 2007;73(4):506-12. doi: 10.1590/S0034-72992007000400009
Published
Issue
Section
License
Copyright (c) 2023 Ana Paula Rossetto, Aline Domingues Chaves Aita, Fabiano Sbicigo Aita, Paulo Ricardo Gazzola Zen, Pricila Sleifer
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
