Altered frequency dynamics of cervical and ocular vestibular evoked myogenic potentials in patients with Ménière's disease.

OBJECTIVE To measure the frequency dynamics of cervical and ocular vestibular evoked myogenic potentials in healthy subjects and patients with Ménière's disease. STUDY DESIGN A prospective cohort study. SETTING A university teaching hospital. SUBJECTS Eight healthy volunteers (16 ears) and 12 adult patients with unilateral Ménière's disease (8 with definite disease and 4 with probable disease) by American Academy of Otolaryngology - Head and Neck Surgery diagnostic criteria. INTERVENTIONS Cervical and ocular vestibular evoked myogenic potentials generated by tone bursts at 250, 500, 750, 1,000, 1,500, 2,000, 3,000, and 4,000 Hz were measured in both groups. MAIN OUTCOME MEASURES The frequency sensitivity of both the cervical and ocular vestibular evoked myogenic potentials, as evaluated by p13-n23 and n10 amplitudes in healthy ears and in ears affected and not affected by Ménière's disease. RESULTS Cervical and ocular vestibular evoked myogenic potentials were present in all ears tested. In the healthy volunteers, the acoustic stimulus frequency at which the response amplitudes were largest was 500 Hz. This shifted to higher frequencies in patients with definite Ménière's disease for both measurements, with the effect being more pronounced for ocular vestibular evoked myogenic potentials. The shift was less marked in the probable Ménière's group and was absent in the unaffected ears of the Ménière's patients. CONCLUSION Ménière's ears display alterations in cervical and ocular vestibular evoked myogenic potentials tuning responses with changes in the latter being more prominent. These findings indicate that the disease process affects both the otolith organs but may have an enhanced effect on the utricle. We propose that this more dominant affect may relate to the anatomical configuration of the utricle.