耳鼻咽喉科・頭頸部外科89巻5号

2017年04月発行

増刊号 臨床力UP！　耳鼻咽喉科検査マニュアル

Ⅱ　めまい・平衡機能検査

6　VEMP（vestibular evoked myogenic potential）

著者： 藤本千里¹

所属機関： ¹東京大学医学部耳鼻咽喉科学教室

ページ範囲：P.143 - P.148

文献概要

●目的

・球形囊〜下前庭神経由来の前庭頸反射系の機能評価（cVEMP）

・卵形囊〜上前庭神経由来の前庭眼反射系の機能評価（oVEMP）


●対象

　めまい・平衡障害を主訴とする患者で，上記を目的とする検査が必要な者。また，めまい・平衡障害の訴えがなくとも，例えば，人工内耳手術の術前に前庭機能を評価するなど，上記を目的とする検査が必要な患者。cVEMPを胸鎖乳突筋から記録する場合は，胸鎖乳突筋の緊張が可能な者。oVEMPを下斜筋から記録する場合は，上方視が可能な者。気導刺激のVEMPを測定する場合は，中耳伝音連鎖の異常による聴力の気骨導差のない者。

参考文献

1）Colebatch JG, et al：Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 42：1635-1636, 1992

2）Colebatch JG, et al：Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 57：190-197, 1994

3）Murofushi T, et al：Physiological and anatomical study of click-sensitive primary vestibular afferents in the guinea pig. Acta Otolaryngol 117：66-72, 1997

4）Murofushi T, et al：Response of guinea pig vestibular nucleus neurons to clicks. Exp Brain Res 111：149-152, 1996

5）Murofushi T, et al：Responses of guinea pig primary vestibular neurons to clicks. Exp Brain Res 103：174-178, 1995

6）Murofushi T, et al：Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis. An indicator of inferior vestibular nerve involvement? Arch Otolaryngol Head Neck Surg 122：845-848, 1996

7）Chihara Y, et al：Vestibular-evoked extraocular potentials by air-conducted sound：another clinical test for vestibular function. Clin Neurophysiol 118：2745-2751, 2007

8）Curthoys IS, et al：The ocular vestibular-evoked myogenic potential to air-conducted sound；probable superior vestibular nerve origin. Clin Neurophysiol 122：611-616, 2011

9）Curthoys IS, et al：Bone conducted vibration selectively activates irregular primary otolithic vestibular neurons in the guinea pig. Exp Brain Res 175：256-267, 2006

10）Iwasaki S, et al：The role of the superior vestibular nerve in generating ocular vestibular-evoked myogenic potentials to bone conducted vibration at Fz. Clin Neurophysiol 120：588-593, 2009

11）Iwasaki S, et al：Ocular vestibular evoked myogenic potentials to bone-conducted vibration in vestibular schwannomas. Otol Neurotol 31：147-152, 2010

12）Iwasaki S, et al：Ocular vestibular evoked myogenic potential elicited from binaural air-conducted stimulations：clinical feasibility in patients with peripheral vestibular dysfunction. Acta Otolaryngol 133：708-713, 2013

13）Murofushi T, et al：Short tone burst-evoked myogenic potentials on the sternocleidomastoid muscle：are these potentials also of vestibular origin? Arch Otolaryngol Head Neck Surg 125：660-664, 1999

14）Murofushi T, et al：Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol Head Neck Surg 127：1069-1072, 2001

15）Shimizu K, et al：Vestibular evoked myogenic potentials in multiple sclerosis. J Neurol Neurosurg Psychiatry 69：276-277, 2000

16）Takegoshi H, et al：Vestibular evoked myogenic potentials in patients with spinocerebellar degeneration. Acta Otolaryngol 120：821-824, 2000

17）Brantberg K, et al：Vestibular-evoked myogenic potentials in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 119：633-640, 1999

18）Streubel SO, et al：Vestibular-evoked myogenic potentials in the diagnosis of superior canal dehiscence syndrome. Acta Otolaryngol Suppl 545：41-49, 2001

19）Fujimoto C, et al：Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo：an analysis using oVEMP and cVEMP testing. Clin Neurophysiol 126：1033-1038, 2015