気道刺激と骨導刺激, oVEMPとcVEMPを臨床の場でどのように使い分けるか?

抄録

Vestibular evoked myogenic potentials (VEMPs) recorded by surface electrodes have been used clinically to assess vestibular function. Cervical vestibular evoked myogenic potentials (cVEMPs), which are recorded from the sternocleidomastoid muscles (SCMs) in response to air-conducted sound (ACS) and bone-conducted vibrations (BCV) have been used to evaluate the functions of the saccule and the inferior vestibular nerve, since physiological and clinical studies have shown that cVEMPs recorded in response to air-conducted sound reflect the functions of the saccular afferents. Ocular vestibular evoked myogenic potentials (oVEMPs), which are recorded from beneath the eyes in response to ACS and BCV, have been considered to represent the vestibular functions mediated by the crossed-otolith ocular pathway. Recent clinical studies have suggested that both oVEMPs in response to ACS, and oVEMPs in response to BCV reflect the functions of the utricle and the superior vestibular nerve. In this paper, I shall explain how cVEMPs to ACS and BCV and oVEMPs to ACS and BCV should be recorded, and how to use these vestibular tests in clinical practice.