A patient with suspected otolith dysfunction undergoes cervical vestibular evoked myogenic potential (cVEMP) testing. cVEMP assesses the integrity of which end organ and nerve pathway?

• A Utricle — superior vestibular nerve — inferior vestibular nucleus
• B Horizontal semicircular canal — superior vestibular nerve
• C Posterior semicircular canal — singular nerve — dorsal neck extensors
• D Saccule — inferior vestibular nerve — cVEMP response via the cervicocollic reflex ✓

Explanation

cVEMP (cervical VEMP) is an inhibitory myogenic potential recorded from the ipsilateral tonically contracted sternocleidomastoid muscle in response to loud sound. It assesses the saccule (which is acoustically sensitive), the inferior vestibular nerve (saccular branch), the vestibulospinal tract, and the cervicocollic reflex arc. Ocular VEMP (oVEMP) assesses the utricle via the superior vestibular nerve. cVEMP is absent or reduced in inferior vestibular neuritis, saccular endolymphatic hydrops (Meniere's), and superior canal dehiscence (paradoxically enhanced in SCD).

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.