Vestibular evoked myogenic potentials of undiagnosed dizziness

Objective Recording of vestibular evoked myogenic potentials (VEMP) can facilitate the evaluation of otolith function. The dizziness caused by otolith lesions is not completely understood. To clarify which symptoms of dizziness originate from the otolith organs, we examined the relationship between symptoms and VEMP results in patients with undiagnosed dizziness. Methods The subjects were 18 patients with undiagnosed dizziness aged less than 40 years who underwent VEMP examination. The VEMP results were evaluated using the interaural ratio of p13-n23 amplitude. Results Abnormal VEMP results were obtained in five of seven patients who experienced a sensation of falling (p = 0.013), in none of the three patients who experienced a swaying sensation (p > 0.05), and in one of eight patients who experienced a floating sensation (p > 0.05). Five of six patients with abnormal VEMP results complained of disequilibrium lasting a few seconds. Conclusions Dizziness with a sensation of falling lasting for a few seconds was related to abnormal VEMP results, suggesting that it resulted from saccular dysfunction. VEMP examination may be considered a useful modality in the diagnosis of dizziness of unknown origin.