Clinical application of cVEMPs and oVEMPs in patients affected by Meniere's disease, vestibular neuritis and benign paroxysmal positional vertigo: a systematic review

Vestibular evoked myogenic potentials (VEMPs) are increasingly used for different pathologies with new clinical insights. Although the study of otolithic function selectively in both its saccular (cervical VEMPs) and utricular (ocular VEMPs) parts does not represent a recent achievement, the clinical utility of this tool is still emerging. The aim of the present report is to define advances in application of VEMPs in diagnosis and clinical study of vestibular neuritis, Meniere's disease and benign paroxysmal positional vertigo. To perform a systematic review of the literature, three appropriate strings were run in PubMed to retrieve dedicated articles. A double cross-check was performed on citations and two independent investigators independently reviewed all full-text articles and performed a comprehensive quality assessment. Of 140 articles identified, 26 articles were included, comprising a total of 1,181 patients affected by vestibular neuritis (296 subjects), Meniere's disease (378 patients) and benign paroxysmal positional vertigo (507 patients). Overall, the use of both cVEMP and oVEMP appeared particularly useful in improving the topographic diagnosis of vestibular neuritis. Most (n = 8) of the studies dedicated to Meniere's disease and benign paroxysmal positional vertigo (10 overall) also reported significantly abnormal VEMP values compared to healthy controls. Although further reports will be necessary to better define normal threshold levels of VEMPs for each pathology, our review suggests that VEMPs may represent a useful aid in improving the diagnostic accuracy for these three common vestibular pathologies.