Comparison of Cervical Vestibular Evoked Myogenic Potentials Before and After The Epley Maneuver in Patients With Posterior Canal BPPV

Year 2025, Volume: 14 Issue: 2, 84 - 90, 29.08.2025

Isa Akin , Akif Güneş , Elif Karalı

https://doi.org/10.47493/abantmedj.1693312

Abstract

Objective: Isolated benign paroxysmal positional vertigo (BPPV) is the most common type of BPPV. Positional maneuvers are the most valuable diagnostic tool for diagnosing the condition. However, the goal was to reveal the change by comparing cervical vestibular myogenic potential (cVEMP) recordings before and after treatment, which is a more objective test for assessing the condition.
Materials and Methods: Our research was carried out within the Audiology Department of the Otorhinolaryngology Clinic at XXX Hospital. During the test, click and tone pulse stimuli at 95 dB were delivered separately to both ears and recorded before treatment, 1 hour after treatment, and 1 week later. P1, N1 latencies and amplitude data were statistically compared.
Results: A notable difference in the P1 and N1 values was detected in the recordings with a tone pulse, when compared to the pre- and post-treatment measurements; however, no significant variation was found in the P1-N1 amplitude values. In the recording with a click stimulus, no significant change in the P1, N1, and P1-N1 amplitude values was observed compared to before treatment.
Conclusion: We believe that the cVEMP test can be used as a cost-effective, easy-to-use, practical, and objective test for BPPV harvesting and that a tone pulse can provide more accurate results than a click pulse in BPPV patients with posterior canal BPPV.

Keywords

Posterior canal BPPV , cervical vestibular evoked myogenic potentials (cVemp) , vertigo

References

• von Brevern M, Bertholon P, Brandt T, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res. 2022;32(1):1–6.
• Kim HA, Lee H. Recent advances in benign paroxysmal positional vertigo. J Neurol. 2021;268(2):491–500.
• Kim JS, Zee DS. Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med. 2014;370(12):1138–47.
• Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope. 2012;122(6):1342–52.
• Zhang X, Ma Y, Wang Y, Zhang Y. Clinical characteristics and VEMP findings in BPPV patients: A meta-analysis. Eur Arch Otorhinolaryngol. 2023;280(6):2409–17.
• Tseng CC, Wang SJ, Young YH. Click and tone burst cVEMP in BPPV before and after canalith repositioning. Acta Otolaryngol. 2020;140(1):49–55.
• Chen G, Yu G, Li Y, et al. Cervical vestibular evoked myogenic potentials in benign paroxysmal positional vertigo: a systematic review and meta-analysis. Front Neurol. 2019;10:1043. doi:10.3389/fneur.2019.01043
• Gunes A, Karali E, Ural A, Ruzgar F. Evaluation of cervical vestibular evoked myogenic potential measures using different stimulus types in patients with posterior canal benign paroxysmal positional vertigo. Acta Otolaryngol. 2020 May;140(5):395-400. doi: 10.1080/00016489.2020.1720920
• Singh NK, Joseph J, Maruthy S. Characteristics of cervical and ocular vestibular evoked myogenic potentials in healthy adults: A comparative study using click and tone burst stimuli. Audiol Res. 2022;12(1):63–71. doi:10.3390/audiolres12010007
• Chen L, Wei D, Zhang Y, et al. Effectiveness of tone burst vs click stimuli in vestibular evoked myogenic potential testing among patients with vestibular dysfunction. Ear Hear. 2023;44(2):342–50. doi:10.1097/AUD.0000000000001339
• Park JS, Kim MB, Lee JD. Recovery of cervical vestibular evoked myogenic potentials after repositioning maneuver in benign paroxysmal positional vertigo. J Audiol Otol. 2021;25(1):6–11. doi:10.7874/jao.2020.00175
• Wang H, Liu Y, Wu Z, et al. Diagnostic value of cervical VEMP parameters in posterior canal BPPV: A prospective study. Clin Neurophysiol. 2020;131(9):2204–10. doi:10.1016/j.clinph.2020.05.016