Cervical Vestibular-Evoked Myogenic Potentials in Sedated Toddlers

Most vestibular disorders in infants and young children manifest not as vertigo or dizziness, but as balance problems and/or developmental delay of motor milestones. Early identification of such disorders is necessary for early intervention.1 It is important to consider a time-efficient, noninvasive, accurate, and comfortable test battery for vestibular assessment that is appropriate for children of all ages. However, selecting tests that are appropriate for use with the pediatric population is a great challenge. Many studies have focused mainly on the application and adaptation of adult tests such as video-nystagmography, computerized dynamic posturography, rotary chair, and cervical vestibular-evoked myogenic potentials (cVEMPs).2–4 Typically, children in these studies were aged 5 years or older, with the exception of the new normative cVEMPs data, wich covers age ranges from a few days through the teen years.3,5–11 Cervical vestibular-evoked myogenic potentials testing is applicable to all subjects, and is gradually becoming a part of the standard vestibular assessment in many clinics. It is a short-latency electromyographic (EMG) response evoked mainly by loud acoustic stimuli. Sound-induced vibrations of the perilymphwithin the saccule are thought to give rise to the cVEMPs. The saccular afferent conduction passes through the inferior vestibular nerve to themedial vestibular nucleus.