Significance of auditory evoked potentials, blink reflex and vestibular evoked myogenic potentials in diagnosis of vertigo

doi:10.3969/j.issn.1672-2922.2016.04.013

Abstract：Objective To investigate the significance of brainstem auditory evoked potentials (BAEP), blink reflex (BR) and vestibular evoked myogenic potentials (VEMP) in the etiological diagnosis of vertigo. Methods Diagnostic data of posterior circulation ischemia (32 cases), benign paroxysmal positional vertigo (20 cases) and Meniere's disease (15 cas-es) were reviewed. A total of 67 patients with vertigo were examined with BAEP and BR and VEMP. Rates of positive re-sults and sensitivity were calculated. Results The rate of positive results in patients with posterior circulation ischemia (PCI) was 62.5%for BAEPs, 68.8%for BR and 0%for VEMP. The rate of positive BAEP or BR results in those with be-nign paroxysmal positional vertigo (BPPV) was also 0%, with VEMP tested positive in 50%in these patients. In patients with Meniere’s disease (MD), the rate of positive BAEP or VEMP tests was 60%but 0%for BR. When rates of positive BAEPs were compared, there was significant difference between patients with PCI or MD and those with BPPV (P<0.01), but not between patients with PCI and those with MD (P>0.05). For BR, the rate of positive results was different between patients with PCI and those with BPPV or MD (P<0.05), but not between patients with BPPV and those with MD (P<0.05). For VEMP, positive test rate was different between patients with BPPV or MD and those with PCI, but not between patients with BPPV and those with MD (P>0.05). Conclusion BAEPs can help distinguish between peripheral vestibular vertigo and central vertigo. BR test is more likely to be positive in central vertigo, and can be a good supplement to BAEPs. VEMP is helpful in identifying peripheral vestibular vertigo. The three electrophysiological tests can complement each other to im-prove diagnostic accuracy.