전정유발근전위: 측정방법과 임상적용

J Korean Neurol Assoc > Volume 28(1); 2010 > Article

Journal of the Korean Neurological Association 2010;28(1): 1-12.

Vestibular Evoked Myogenic Potential: Recording Methods and Clinical Application

서명환, 정성해a 김지수b

단국대학교병원 이비인후과, 충남대학교병원 신경과a, 서울대학교 의과대학 신경과학교실, 분당서울대학교병원 신경과b

전정유발근전위: 측정방법과 임상적용

Myung-Whan Suh

Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, KoreaDepartment of Neurologya, Chungnam National University Hospital, Daejeon, KoreaDepartment of Neurologyb, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Only a few tests can evaluate the function of the saccule and inferior vestibular nerve. Vestibular-evoked myogenic potentials (VEMP) are inhibitory potentials recorded in the contracting muscles, usually in the sternocleidomastoids (SCM), when sound stimuli are applied. A disynaptic pathway originating in the saccule is known to mediate VEMP. The main pathway of saccule-induced inhibitory postsynaptic potentials to ipsilateral SCM motoneurons seems to be the medial vestibulospinal tract which descends within the medial longitudinal fasciculus. VEMP have been applied to determine saccular function in many disorders involving the peripheral vestibular apparatus. However, the characteristics and the diagnostic values of VEMP require further exploration in central vestibulopathies. In this review, the basic principles and recording methods of VEMP are overviewed. We will also review VEMP responses found in central as well as peripheral vestibular disorders. Despite several issues that need further elucidation, such as the exact neural pathway mediating VEMP, aging effects on VEMP, and normalization of the muscle contraction during the recording, VEMP allows us exclusive information on the function of saccule and its neural pathway, which cannot be provided by other vestibular function tests. KeyWords:Vertigo, Vestibular-evoked myogenic potential, Peripheral vestibulopathy, Brainstem, Cerebellum