Development of ocular vestibular-evoked myogenic potentials in small children.

OBJECTIVES/HYPOTHESIS This study investigated the development of otolithic-ocular reflex in small children (<3 years old) via the ocular vestibular-evoked myogenic potential (oVEMP) test. STUDY DESIGN Prospective study. METHODS Twenty full-term newborns (group A), 15 children aged 1 to 3 years (group B), and 15 children aged 4 to 13 years (group C) were enrolled in this study. All children underwent auditory brainstem response testing or audiometry, and the oVEMP test. RESULTS All subjects had normal hearing. Typical biphasic oVEMP waveforms were not observed in the 20 newborns, but were present in six (40%) of 15 children aged 1 to 3 years and all (100%) children aged 4 to 13 years, exhibiting a significant difference. In group B, except for the nine children aged 12 to 24 months, the remaining six children, aged 25 to 47 months, had clear oVEMPs, with the mean nI latency and nI-pI amplitude resembling those in children aged 4 to 13 years, indicating that the otolithic-ocular reflex is mature in children aged >2 years. CONCLUSIONS Despite the well-developed caloric and cervical VEMP responses in early life, oVEMPs are not present in newborns, but are present in children aged >2 years who can walk with a gait resembling an adult. Maturation of the otolithic-ocular reflex is important to balance control, which is necessary in small children for independent gait.