Clinical Significance of Frequency Tuning in Cervical VEMP: A Narrative Review

Cervical vestibular evoked myogenic potentials (cVEMP) are an established clinical tool for evaluating saccular function and the inferior vestibular nerve pathway. Traditionally, cVEMP interpretation is based on parameters such as peak latencies, response amplitude, and interaural asymmetry ratio. However, these conventional measures may not always detect early or frequency-specific vestibular abnormalities. In recent years, attention has shifted toward the analysis of cVEMP frequency tuning, which reflects the frequency-dependent responsiveness of the saccule. In normal individuals, cVEMP amplitudes typically demonstrate a peak response around 500 Hz, producing a characteristic bell-shaped tuning curve. Deviations from this pattern have been reported in several vestibular disorders, including Meniere?s disease, Superior semicircular canal dehiscence, Vestibular neuritis, and Otosclerosis. Frequency tuning assessment offers additional diagnostic insight, improves differentiation between vestibular pathologies, and complements routine vestibular test batteries. This narrative review discusses the physiological basis of cVEMP frequency tuning, normative tuning characteristics, disorder-specific alterations, and the clinical relevance of incorporating frequency tuning into routine vestibular evaluation.