Around 30 percent of people experience vertigo, a form of severe dizziness that can result in a loss of balance, a feeling of falling, trouble walking or standing, or nausea. It is a common reason for visits to the GP or Emergency, particularly in older people, but is treatable in most cases.
A new study, published in Neurology, for the first time documents patients using miniature video goggles to capture episodes of vertigo in their home. Researchers were then able to use the videos to identify eye-movements associated with different conditions.
Senior author on the study Associate Professor Miriam Welgampola said vertigo can be a symptom of a number of different conditions, including stroke in rare instances, so it is important that the cause is identified as soon as possible.
“Vertigo can be a disabling condition, so an accurate diagnosis is important to effectively treat the underlying disorder,” said Associate Professor Welgampola of the University’s Faculty of Medicine and Health and the Institute of Clinical Neurosciences, Royal Prince Alfred Hospital. “Observing a person’s eye movements during an episode can help make the diagnosis, but people don’t always have an episode when they are at the doctor’s office.”
In this proof of concept study, researchers taught patients who were already diagnosed with three common causes of vertigo to video record their own episode of vertigo.
Of the group, 43 people had Meniere’s disease, an inner ear disorder that can affect hearing and balance, 67 had vestibular migraine that can cause vertigo but may not cause a headache, and seven had benign paroxysmal positional vertigo, one of the most common causes of vertigo, where a person’s head movements trigger the episodes.
The diagnostic yield of the googles was slightly different for each condition, however for Meniere’s disease the googles were able to provide very high accuracy of diagnosis similar to in-clinic hearing tests which can generally only be completed when a patient’s condition is more progressed.
“These results indicate that it is possible for patients to record their own episodes of vertigo and for health professionals to apply these principals when viewing the video footage to rapidly and accurately diagnose the cause of the vertigo,” said lead author Allison Young, PhD Scholar in the University’s Vestibular Research Laboratory and the Institute of Clinical Neurosciences, RPA.
“While further studies are needed in larger groups, providing people with a pair of goggles that they can easily use at home to record eye movement has the potential to help with vertigo diagnosis not only by a neurologist in a clinic, but also by physicians in an emergency room and physicians diagnosing patients remotely as well,” said Welgampola.
The study records some limitations including that four participants did not feel well enough to wear the goggles when experiencing vertigo. Additionally, others did not wear them when they thought their vertigo was too mild. Clinicians making the final diagnosis were not blinded to the video recordings. Also, some medications taken for vertigo may have influenced eye movement.
The research team are currently conducting larger scale studies examining the effectiveness of using the goggles for diagnosis in the RPA Emergency Department.
Disclosures: The study was funded by the Garnett Passe and Rodney Williams Memorial Foundation and the National Health and Medical Research Council of Australia. Two authors on the study are unpaid consultants for Otometrics.