Fife Terry D, Satya-Murti Saty, Burkard Robert F, Carey John P
Department of Neurology (TDF), Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix; Health Policy Consultant (SS-M), Santa Maria, CA; Department of Rehabilitation Science (RFB), University of Buffalo, NY; and Department of Otolaryngology-Head and Neck Surgery (JPC), Johns Hopkins School of Medicine, Baltimore, MD.
Neurol Clin Pract. 2018 Apr;8(2):129-134. doi: 10.1212/CPJ.0000000000000430.
A recent American Academy of Neurology Evidence-Based Practice Guideline on vestibular myogenic evoked potential (VEMP) testing has described superior canal dehiscence syndrome (SCDS) and evaluated the merits of VEMP in its diagnosis. SCDS is an uncommon but now well-recognized cause of dizziness and auditory symptoms. This article familiarizes health care providers with this syndrome and the utility and shortcomings of VEMP as a diagnostic test and also explores payment policies for VEMP.
In carefully selected patients with documented history compatible with the SCDS, both high-resolution temporal bone CT scan and VEMP are valuable aids for diagnosis. Payers might be unfamiliar with both this syndrome and VEMP testing.
It is important to raise awareness of VEMP and its possible indications and the rationale for coverage of VEMP testing. Payers may not be readily receptive to VEMP coverage if this test is used in an undifferentiated manner for all common vestibular and auditory symptoms.
美国神经病学学会近期发布的一项关于前庭肌源性诱发电位（VEMP）检测的循证实践指南描述了半规管裂综合征（SCDS），并评估了VEMP在其诊断中的价值。SCDS是一种罕见但目前已得到充分认识的头晕和听觉症状病因。本文旨在让医疗服务提供者熟悉该综合征以及VEMP作为诊断测试的效用和缺点，同时探讨VEMP的支付政策。
在精心挑选的、有与SCDS相符病史记录的患者中，高分辨率颞骨CT扫描和VEMP都是有价值的诊断辅助手段。支付方可能对该综合征和VEMP检测都不熟悉。
提高对VEMP及其可能适应症的认识以及VEMP检测覆盖的基本原理很重要。如果对所有常见的前庭和听觉症状不加区分地使用该检测，支付方可能不会轻易接受VEMP检测的覆盖。
