A patient with bilateral vestibular loss on VNG (absent caloric responses bilaterally) undergoes ocular VEMP (oVEMP) testing. Which pattern is most likely?

• A Absent oVEMP bilaterally ✓
• B Normal oVEMP bilaterally
• C Asymmetric oVEMP with larger amplitude on one side
• D oVEMP present only to high-intensity stimuli bilaterally

Explanation

Bilateral vestibular loss affecting the superior vestibular nerve and utricle will result in absent oVEMPs bilaterally. oVEMP assesses utricular function via the superior vestibular nerve. Normal oVEMPs would argue against the diagnosis. Asymmetric responses suggest unilateral disease. The question describes end-organ loss, not merely threshold elevation.

Reference: Vertigo and Disequilibrium, 1st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.