Cervical Vestibular-Evoked Myogenic Potentials:

                                     Vestibular evoked myogenic potentials 

(VEMPs) are short-latency, vestibular-dependent reflexes that are recorded from the sternocleidomastoid (SCM) muscles in the anterior neck (cervical VEMPs or cVEMPs) and the inferior oblique (IO) extraocular muscles (ocular VEMPs or oVEMPs).

VEMP testing is used to evaluate whether certain vestibular organs and associated nerves are intact and functioning normally. Responses in this test are measured from different muscles in the neck and around the eyes.

VEMP is a relatively new vestibular function test performed by stimulating one ear with repetitive pulse or click sound stimulation and then measuring surface EMG responses over selected muscles averaging the reaction of the muscle electrical activity associated with each sound click or pulse. The clinical application of VEMP was first reported by Colebach in 1994 but had its basis in even earlier work in the vestibular field.1 While VEMP testing has been increasingly used throughout the world, its use in the United States has been more limited.

 Recently, the American Academy of Neurology published an evidence-based practice guideline on the use of VEMP. In addition, in October 2015 the FDA approved VEMP equipment by GN Otometrics (Schaumburg, IL) for sale in the United States. In March 2017, Interacoustics (Middelfart, Denmark) and in September 2017 Intelligent Hearing Systems (Miami, FL) were also granted FDA approval to market VEMP equipment sales. This article is intended to help clinicians incorporate the conclusions of the recently published practice guideline2 and to offer special attention to payment policy issues for this new diagnostic test.