Diagnosis of Vestibular Diseases Using VEMP and vHIT

Abstract

In this review, the author reviewed the change of diagnosis of vestibular diseases from the appearance of VEMP (vestibular evoked myogenic potential) and vHIT (video head-impulse test). VEMP is a clinical test for disorders of the otolith organ, while vHIT is a clinical test for disorders of the semicircular canals. Using VEMP and vHIT, it is possible to assess all parts of the vestibular labyrinth at a clinic. VEMP enables clinicians to diagnose “otolithic vertigo/dizziness” and “inferior vestibular neuritis”. Furthermore, VEMP provides valuable information for the diagnosis of endolymphatic hydrops, superior canal dehiscence syndrome, and impairments of the vestibulo-spinal tract and medial longitudinal fasciculus. In addition to the diagnosis of bilateral vestibulopathy and vestibular neuritis, vHIT also enables clinicians to diagnose impairments of the vertical semicircular canals, especially isolated posterior semicircular canal dysfunction. Finally, the author wishes to emphasize that combined use of VEMP and vHIT is very important because combinations of abnormal findings in these tests could provide us with clues to clarifying the etiology and pathophysiology.