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

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.