A 40-year-old patient undergoes vestibular evoked myogenic potential (VEMP) testing. Cervical VEMP (cVEMP) tests which structure's function, and what is the stimulus used?

• A Saccule via loud sound stimuli recorded from ipsilateral sternocleidomastoid ✓
• B Utricle via caloric stimulation at 30°C and 44°C
• C Utricle via galvanic vestibular stimulation recorded from ocular muscles
• D Semicircular canals via rotation chair recording from trapezius

Explanation

Cervical VEMP (cVEMP) assesses saccular function via the inferior vestibular nerve pathway. Loud sound stimuli (typically 500 Hz tone burst or click at 90–100 dB nHL) activate the saccule, which projects through the inferior vestibular nerve to the ipsilateral sternocleidomastoid muscle, producing a characteristic biphasic inhibitory response (p13-n23). Ocular VEMP (oVEMP) tests utricular function. Caloric testing assesses horizontal semicircular canal function. Understanding this distinction is critical for localizing lesions in superior vs inferior vestibular neuritis.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.