IHS Training Session: Acquiring VEMP Responses using SmartEP

This SmartEP training session covers the theory being the acquisition of Vestibular Evoked Myogenic Potentials, including cervical (cVEMP) and ocular (oVEMP). Material covers the use of different stimulators, electrode placement, settings, peak marking, comparison, and analysis.

Learn more about SmartEP VEMP modality at: https://ihsys.info/site/en/diagnostic...

00:19 - Balance System Overview
01:30 - What is a VEMP
05:23 - Diagnostic Utility
06:41 - Eliciting a VEMP Response
07:33 - Importance of EMG Monitoring
10:27 - EMG Acceptance and Rejection
14:14 - cVEMP Testing
14:54 - cVEMP Electrode Montage
17:42 - cVEMP Acquisition Parameters
20:54 - Understand Patient Feedback and EMG Levels
29:08 - Setting EMG Acceptance Min and Max
33:35 - VEMP Acquisition Flowchart
34:44 - Sample cVEMP Acquisition Process
38:42 - VEMP Interpretation using Asymmetry Ratios
41:42 - oVEMP Testing
42:40 - oVEMP Acquisition Parameters
43:08 - oVEMP Electrode Montage
44:14 - Placement of the oVEMP Visual Target
47:54 - Pathology Response Indicators
48:07 - VEMP CPT Codes
49:04 - Conclusions

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Literature References:

Curthoys, Ian. (2020). "The Anatomical and Physiological Basis of Clinical Tests of Otolith Function. A Tribute to Yoshio Uchino." Frontiers in Neurology. 11. 10.3389/fneur.2020.566895

Colebatch JG, Halmagyi GM, Skuse NF. (1994) "Myogenic potentials generated by a click-evoked vestibulocollic reflex." Journal of Neurology, Neurosurgery, and Psychiatry, 57, 190-197.

Murofushi T, Curthoys IS. (1997) "Physiological and anatomical study of click sensitive primary vestibular afferents in the guinea pig." Acta Otolaryngol (Stockh), 117, 66-72.

Halmagyi GM, Curthoys IS. (1999) "Clinical testing of otolith function." Annals of the New York Academy of Sciences, 871, 195-204.

Akin FW, Murnane OD. (2001) "Vestibular evoked myogenic potentials: preliminary report." Journal of the American Academy of Audiology. 2001 Oct;12(9):445-52.

Welgampola MS, Colebatch JG. (2001) "Vestibulocollic reflexes: normal values and the effect of age." Clinical Neurophysiology, 112, 1971-1979

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Third Party Images used:

"Structures of the Vestibular Apparatus " from https://anatomytool.org by Cenveo, license: CC BY

"Extraocular muscles illustration" from Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013.

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Corrections:
20:50 The Maximum RMS should be set to 1000
23:00 The Maximum RMS should be set to 1000
30:00 The Maximum RMS should be set to 1000
31:30 The Maximum RMS should be set to 1000