Which nerve is associated with cVEMP responses?

• A. Superior vestibular nerve
• B. Cochlear nerve
• C. Inferior vestibular nerve
• D. Facial nerve

Answer: (C)

cVEMP responses reflect a vestibulocollic reflex that starts with the saccule, an otolith organ, sending input through the inferior vestibular nerve. When a loud sound or tone burst stimulates the saccule, the signal travels via the inferior vestibular nerve to the brainstem vestibular nuclei and then down to the sternocleidomastoid muscle through the spinal accessory nerve. The muscle response is what we record in cVEMP testing.

This is why the inferior vestibular nerve is the nerve associated with cVEMP. The superior vestibular nerve carries input from the utricle and semicircular canals, not primarily the saccule. The cochlear (auditory) nerve handles hearing, and the facial nerve is motor to facial muscles, not part of this reflex pathway.