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VIDEO – Vestibular Evoked Myogenic Potentials (cVEMPs) – 6 Pediatric PEARLS

At AIB we perform and obtain reliable Vestibular Evoked Myogenic Potentials (C-VEMPs) on infants and children quite easily. Here are several videos, which illustrate some techniques. It may vary from the infant laying on the parent’s lap, or resting comfortably, to collection during a righting reflex. The modifications we use are based on infants-child’s age. The sternocloidomastoid muscle (SCM) must be activated, during testing, as the cVEMP is an “off” EMG response.

PEARLS
1.) It is helpful to fully palpate the muscle prior to electrode placement, which will ensure a solid placement on the belly of the muscle.
2.) No need to scrub- just get the electrode to stick on clean-dry skin, this is a huge EMG response.
3.) Focus more on lateral flexion, which is the primary function of the SCM, rather than trying for a full rotation. This is also true for adults.
4.) This lateral flexion can be accomplished by playing with the child and watching for the physical state of the flexed SCM prior to starting data collection.
5.) Relax- unlike BAER, we want the child to be active-awake and there is no issue of background noise. Play and have fun.
6.) Remember, a conductive loss affects VEMP so always know middle ear status prior to interpretation of an absent response.