The effect of reposition maneuvers on the cervi̇kal vesti̇bular evoked potanti̇als in benign paroxismal positive vertigo disease

Aim: Benign paroxysmal positional vertigo (BPPV) is the most frequent cause of vertigo. Making the correct diagnosis as well as treatment depends mainly on the patient history and the positional nystagmus evoked during positional maneuvers. Objective neuro-otological tests need to be developed to understand the underlying exact pathogenetic mechanism. Vestibular evoked myogenic potentials (VEMPs) can make contributions to the understanding of the pathophysiological mechanisms underlying BPPV. They may also help to determine the therapeutic efficacy of the maneuvers. Methods: Our study was performed in our neurosensorial unit at the Neurology Clinic of Ege University Medical Faculty Hospital (EUTFH). Cervical VEMP test was performed using Synergy EMG (Medelec; Viasys Healthcare UK Ltd 2009). During the test, 110 decibels sound stimuli were given separately from each of the two ears. These response stimuli were recorded at intervals of 100 milliseconds and averaged 250 times. 3 electrodes (active, reference and ground) were used for the measurements. The active electrode was recorded to middle of the ipsilateral sternocleidomastoid muscle. P13, N23 latencies and corrected amplitude values of the healthy and patient groups were recorded. Statistical analyzes were performed. Results: Before the treatment, P13 latency was recorded as 13.51 ± 1.99 milliseconds (msn), the N23 latency values were 22.44 ± 2.22 and the corrected amplitude value was 6.44 ± 3.49. The P13 and N23 latencies were prolonged compared to the control group. After the treatment, P13 latency was 12.87 ± 1.65, N23 latency 121.97 ± 1.95 corrected amplitude was 5.75 ± 2.5. In the post-treatment responses, only P13 latency improved, and N23 and amplitude values did not different before and after treatment. Conclusion: We think that the VEMP test is a noninvasive, cost-effective and practical test that allows the evaluation of vestibular-ocular and vestibule-spinal pathways at the brain stem between otolithic organs and effector muscles in BPPV patients.