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HNO

, Volume 58, Issue 11, pp 1129–1144 | Cite as

Die Ableitung zervikaler und okulärer vestibulär evozierter myogener Potenziale

Teil 2: Einflussfaktoren, Bewertung der Befunde und klinische Bedeutung
  • L.E. WaltherEmail author
  • K. Hörmann
  • O. Pfaar
CME Weiterbildung · Zertifizierte Fortbildung

Zusammenfassung

VEMP-Messungen unterliegen unterschiedlichen Einflüssen: Alter des Patienten, Reizschwelle, Reizlautstärke und Reizfrequenz. Mit Luft- (AC) und Knochenleitungsreizen (BC) werden die vestibulären Rezeptoren und Afferenzen der Otolithenorgane in unterschiedlichem Ausmaß stimuliert. Klinisch stehen die zervikal abgeleiteten VEMP (cVEMP) sowie die okulären (oVEMP) zur Verfügung. AC-cVEMP stellen vorwiegend einen Indikator für die sacculocollische Reflexstrecke dar. VEMP ermöglichen zusammen mit Befunden des vestibulookulären Reflexes (VOR, Bogenganganalyse) und ergänzender Otolithentests die seitengetrennte Analyse der Otolithenfunktion. Auch die Abgrenzung von kombinierten oder isolierten Bogengang- und Otolithenfunktionsstörungen im Sinne einer Subtypisierung von Schädigungsmustern bei ein- und beidseitigen Affektionen, wie der Neuritis vestibularis oder der bilateralen Vestibulopathie, ist möglich. Darüber hinaus gewinnt der Einsatz von VEMP bei prognostischen und therapeutischen Fragestellungen sowie bei der Begutachtung an Bedeutung.

Schlüsselwörter

Schwindel Otolithen Sacculus Utriculus Okuläre vestibulär evozierte myogene Potenziale (oVEMP) Zervikale vestibulär evozierte myogene Potenziale (cVEMP) 

Recording cervical and ocular vestibular evoked myogenic potentials

Part 2: Influencing factors, evaluation of findings and clinical significance

Abstract

VEMP measurements are subject to various influencing factors: patient age, threshold, sound intensity and frequency. Using air (AC) and bone conduction (BC) the vestibular receptors and afferents of the otolith organs can be activated to varying degrees. Recordings of cervical (cVEMP) and ocular VEMP (oVEMP) are clinically possible. AC-cVEMP are primarily an indicator of the sacculocollic reflex pathway. Together with findings on the vestibuloocular reflex (VOR) and complimentary otolith tests, VEMP enable otolith function analysis of each side separately. In addition, the distinction between combined or isolated canal and otolith dysfunction in terms of subtyping and patterns of damage in mono- and bilateral disorders, such as vestibular neuritis or bilateral vestibulopathy, is possible. Moreover, VEMP is relevant in terms of prognostic and therapeutic considerations as well as expert assessments.

Keywords

Vertigo Otoliths Sacculus Utriculus Ocular vestibular evoked myogenic potentials (oVEMP) Cervical vestibular evoked myogenic potentials (cVEMP) 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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© Springer-Verlag 2010

Authors and Affiliations

  1. 1.HNO-GemeinschaftspraxisSulzbach (Taunus)Deutschland
  2. 2.Universitätsklinikum Mannheim der Ruprecht-Karls-Universität HeidelbergMannheimDeutschland

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