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oVEMP Testing with Eclipse

What is oVEMP? How to Test?

The Ocular Vestibular Evoked Myogenic Potential
(oVEMP) is an evoked potential measured from the
extraocular muscles and is used to assess the
vestibular system. There is still much debate over
the origin of the response (utricle, or saccule and
1
utricle) , however, the oVEMP is largely dependent
2
on the integrity of the superior vestibular nerve .
The oVEMP is recorded using surface electrodes at
four sites on the face and an Amplitude Asymmetry
Ratio is calculated to determine if the above-
mentioned parts of the vestibular system are intact
and working normally.
Patient Preparation is very important. The
electrode sites must be prepared and cleaned in
order to obtain acceptably low skin impedance. It is
recommended to have impedance values be 3kΩ or
lower. The impedance values between one another
should be balanced or similar in value.
The reference electrodes should be placed as close
as possible underneath the inner corner of the eye.
The subject is either seated or in a semi-recumbent
position and is instructed to maintain an upward
gaze at approximately 25-30% above the horizontal
for the duration of the recording. Placing a static
visual target on the wall or ceiling for the patient to
look at during testing will ensure consistent
activation of the muscle.

Electrode Placement (example):

3 Use of this electrode montage does not require the

Figure 1: oVEMP recordings from a normal young adult
active (white) electrode to be shifted during testing.

The oVEMP response is recorded from underneath

Why VEMP?
The oVEMP is a test used in addition to the
traditional testing to assess the vestibular system
(ie, VNG) and provides information to assist in the
diagnosis of disorders such as Meniere’s disease
and Superior Semicircular Canal Dehiscence
(SSCD).
the contralateral eye. Therefore, the right (red)
electrode is placed under the left eye while the right
ear is stimulated.
The air-conduction stimulus used is a 500Hz 2-0-2
Tone Burst at high intensity level (e.g., 95dBnHL)

___________________________________ Ensure that the patient is relaxed prior to starting the

1 test. After confirming impedances, ensure that the
Pike, E.G., Jacobson, G.P., McCaslin, D.L., & Hood, L.J. (2011).
Normal characteristics of the ocular vestibular evoked myogenic
“-20dB” button on the Preamplifier is activated.
potentional. J Am Acad Audiol, 22, 222-230.

2
Jacobson et al. (2011). Patterns of abnormality in cVEMP,
oVEMP and caloric tests may provide topological information
about vestibular impairment. J Am Acad Audiol, 22,601-611.

3
Murnane, O.D., & Akin, F.W. (2009). Vestibular evoked
myogenic potentials. Seminars in Hearing, 30(4), 267-280.

Version 1 – 11/2012
 Interacoustics A/S • Phone: +45 6371 3522 • Fax: +45 6371 3522 • info@interacoustics.com • www.interacoustics.com

Basic oVEMP Testing Procedure

Setting up the Eclipse
The Eclipse comes with pre-programmed protocols
so the system is ready to use immediately. Protocols
can be created or modified easily to fit your clinic
need. Consult your manual to learn how to create or
modify a protocol. The procedure described below is
simply a suggested test process and to be used only
as a guideline.
Choose the O VEMP protocol from the dropdown
menu:
Marking Peaks
Only waveforms that are completed may be marked.
This is done from the Edit sheet.
To mark a waveform, double click the waveform
handle you would like to mark. Right click, and then
choose the correct marker. Drag your mouse to the
correct area and click. You can also choose 1-4 on
the keyboard to bring up the appropriate marker and
use Enter to place it.
The oVEMP response is well documented and is said
to be represented by two distinct peaks; N1 occurring
at approximately 10 ms and P1 occurring at
approximately 15 ms.

The oVEMP test should be run in the Manual Mode.

Manual Mode
To begin the manual mode, choose the intensity and
select the ear to test on the Record sheet. Instruct
the patient to look up without moving their head.
Next choose Start or hit F2.
100-200 sweeps are typically collected per waveform.
After collection, choose a left or right ear by double Reporting
clicking the waveform handle. Next, right click the
waveform handle of the opposite ear and select “Set Choose the Report Icon
as VEMP Partner”. These selected waveforms will be When complete, choose Save and Exit.
used in the Asymmetry Calculation.

EMG Scaling Alternative Electrode Placement (examples):

The default protocol is setup to scale the curves
automatically. Some prefer to scale after the
recordings are completed. After the recording is
complete, you can right click on the waveform and
choose EMG Scaling. Waveforms will then be
scaled according to the average of the EMG
values recorded throughout the collection. This
will make individual recordings comparable, even
though slightly different degrees of muscle tonus
may have been applied during the different
recordings.
Electrode montage for testing left ear.
HINT: Display Scaling can be increased or decreased by
using the arrows on the top left side of the recording For the right ear, move active (white) electrode to
window or by using your keyboard arrows. other side (underneath red electrode).

Version 1 – 11/2012