Inter-frequency amplitude ratio of oVEMP for differentiating Meniere’s disease from BPPV: clinical validation using a double-blind approach

Abstract

Objective: The study aimed at examining the usefulness of inter-frequency amplitude ratio (IFAR) of ocular vestibular evoked myogenic potential (oVEMP) in identifying Meniere’s disease (MD) and differentiating it from benign paroxysmal positional vertigo (BPPV).Design: A case-control design was used with a double blind approach. Phase 1 included 70 healthy individuals and 36 individuals each with MD and BPPV and Phase 2 included 20 individuals each with MD and BPPV. The age range of the participants in both phases was 15–50 years. All participants underwent oVEMP testing using 500 and 1000?Hz tone bursts and IFAR was obtained.Results: The results in phase 1 revealed significantly higher IFARs in Meniere’s disease than BPPV and healthy individuals (p?<?0.001). An optimum criterion point of IFAR ?1.11 for diagnosing MD was found which yielded 80% sensitivity and 98% specificity. The results in phase 2 demonstrated 85% correct identification of MD and 95% correct rejection of BPPV as non-MD.Conclusions: IFAR of oVEMP appears highly sensitive and specific parameter for identifying MD and a clinically valid tool for differentiating MD from BPPV.