A web-based system helps Benign Paroxysmal Positional Vertigo (BPPV) patients self-diagnose and treat recurrent vertigo, results from a randomized controlled trial show.
“BPPV appears to be a vestibular disorder that is well suited for telemedicine and digital therapy,” write the researchers, led by Hyo-Jung Kim, Ph.D. in Korea.
“Thus, the system employed in this study has potential for use by primary care physicians, particularly when making provisional diagnoses over the phone and during consultations when provocative maneuvers are ambiguous or cannot be performed. There is,” they wrote.
The study was published online on January 17. Department of Neurology, JAMA.
common and recurrent
BPPV is the most common type of vertigo and often recurs. BPPV occurs when small canalicular particles in one part of the inner ear (the ear conia) break off and fall into the semicircular canals in another part, causing a false sense of rotation.
Canalicular repositioning maneuver (CRM) is relatively easy for patients to perform, with immediate resolution of BPPV in approximately 80% of patients after a single application, with repeat success rates jumping to 92%. However, since the CRM is canal-specific, it is important to accurately identify the affected canals.
In a previous study, investigators found that six simple questions could diagnose associated canal and BPPV types with 71% accuracy.
The current trial tested the efficacy of web-guided CRM self-administration following a questionnaire-driven diagnosis in recurrent BPPV.
They enrolled 585 patients previously diagnosed with BPPV who were successfully treated with CRM, half randomized to the treatment group and the other half to the control group.
The treatment group (mean age 60 years, 64% women) completed an online questionnaire for diagnosis and how to self-manage their CRM according to the type of BPPV diagnosed when experiencing positional vertigo again. I have received the video clip.
A control group (mean age 61 years, 71% female) received video clips for CRM self-administration according to the type of BPPV diagnosed at enrollment.
Overall, 128 (22%) individuals experienced a recurrence of BPPV (58 in the treatment group and 70 in the control group), with an average interval between episodes of 180 days.
In the intention-to-treat analysis, significantly (P. < .001) More patients in the treatment group (42 of 58, 72.4%) experienced resolution of dizziness after using the web-based system than in the control group (30 of 70, 42.9%). reported.
Comments on survey results Medscape Medical NewsShaheen Lakhan, MD, a neurologist and researcher in Boston, Massachusetts, said the study “is a shining example of empowering people with guided self-diagnosis for the ubiquitous neurological disorder BPPV.” .
“Then we took another big step and showed that web-based therapy without a single human on the other side could solve brain diseases,” Lakhan said.
“We need to see more clinical studies of these for conditions such as migraine, chronic pain, and light-headedness, so these can become mainstream diagnoses and interventions,” Lakhan added.
This research was supported by the Korea Medical Technology Research and Development Project, Ministry of Health and Welfare, Korea. Ah Patents issued to DZMED Inc and Patents for Devices, Methods, and Computer Programs for Self-Diagnosis and Treatment BPPV is On hold. Kim receives royalties from his DZMED Inc and holds stock in the company. Lakhan has no relevant disclosures.
JAMA Neurology. Published online on January 17, 2023.
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