• Home
• Introduction
• What is Positional Vertigo?
• Symptoms of Positional Vertigo
• Diagnosis of Positional Vertigo
• How is Positional Vertigo Treated?
• How the VertiGONE System Works
• National Institutes of Health Study
• The Background Study
• The Committee
• The Study
• Co-investigators
• National Institutes of Health Committee
• Chairperson
• Members
• Scientific Review Administrator
• Grants Technical Assistants

INTRODUCTION

The VertiGone Goggle is an innovative device used in the relief of the symptoms of benign paroxysmal positional vertigo ( also known as positional vertigo, benign vertigo, BPPV and BPV). This innovative goggle, developed and patented by Philip Anthony, M.D., an expert in positional vertigo and a board certified otologist in Fort Worth, Texas, provides relief for the traditional symptoms of vertigo by guiding the patient through a Classic Epley maneuever.

WHAT IS POSITIONAL VERTIGO?

Positional vertigo is an inner ear abnormality caused by the release of small calcium carbonate crystals, or otoconia, in the inner ear. These crystals are created by the utricle. These calcium carbonate crystals have exactly the same crystalline structure as the calcium carbonate components of bone. These small crystalline structures are normally attached to hair cells in a small organ of the inner ear (utricular macula), they respond to gravity, and they tell the brain which direction is down.

When these calcium carbonate crystals come loose, either by head trauma, infection, or through the degenerative process of the inner ear, they fall free within the ear causing dizziness, vertigo, and imbalance. When the patient is upright, the calcium carbonate crystals settle to the bottom of the posterior semicircular canal. When the patient puts the affected ear downward, the calcium carbonate crystal pile moves from the bottom to the mid portion of the posterior semicircular canal causing the fluid in the posterior semicircular canal to move and make the patient dizzy.

Approximately 3 million Americans experience vertigo each year and nearly 42% of Americans experience vertigo during their lifetimes. Classic positional vertigo makes up 17% of all patients who suffer from dizziness. Nonclassic incidences of positional vertigo comprise up to 35% of patients. The incidence of positional vertigo in the United States is 64 new cases per 100,000 population per year. The incidence has been reported from 10 to 100 per 100,000 population per year in various countries. Positional vertigo tends to recur. Up to 30% of patients who have positional vertigo and are treated will have recurrence within one year. Some authors report as high as 50% recurrence of positional vertigo over time over a 5-year period. Positional vertigo is known to resolve spontaneously over 6 weeks.

SYMPTOMS OF POSITIONAL VERTIGO

The classic symptoms of positional vertigo are disorientation with looking up, looking down, lying down into bed, sitting up from lying, standing from a sitting position, and particularly rolling over in bed into the affected ear downward position. Activities that bring on symptoms vary, but the classic finding of positional vertigo is dizziness preceded by a change of position of the head with respect to gravity. Getting out of bed or rolling over in bed is a common motion that prompts vertigo. BPPV may be present for a few weeks, then stop, and then come back again.

DIAGNOSIS OF POSITIONAL VERTIGO

Physicians can diagnose positional vertigo through a complete history, physical examination and auditory and vestibular test. The key observation used to diagnose positional vertigo is that the patient experiences dizziness triggered by lying down or from rolling over in bed. The classic diagnostic method to diagnose positional vertigo is the right and left Dix-Hallpike maneuver, which also identifies which ear is affected.

The Dix-Hallpike maneuver moves a patient from a sitting to a supine position, with the head turned 45 degrees to one side and the neck extended about 20 degrees backward. Approximately 10 to 40 seconds after the patient is moved, he or she will experience the onset of vertigo and some rotary eye movements. The ear downward, which causes the most dizziness, is the ear affected by the positional vertigo.

HOW IS POSITIONAL VERTIGO TREATED?

The optimal method of treatment for positional vertigo is the use of the Epley, or canalith repositioning, maneuver. The Classic Epley maneuver can provide immediate relief for 20% of patients. In the remaining 80%, patient symptoms worsened for 36 hours and then improved.

HOW THE VertiGONE SYSTEM WORKS

The VertiGONE Goggle works by guiding a patient through an accurately and effectively performed Epley maneuver providing both physician and patient with visual feedback to guide them through the correct head positions of the classic Epley maneuver. The Epley maneuver resolves the patient’s dizzy symptoms, dizziness-related nausea, vertigo and lightheadedness. The VertiGONE Goggle is currently undergoing a study, funded by the National Institutes of Health (NIH), to determine the thoroughness and advantages of its use to resolve positional vertigo.

The VertiGONE Goggle consists of molded plastic, an elastic strap to secure the goggle to the head, and two visual feedback mechanisms; one to guide the practitioner and one to guide the patient through the maneuver correctly. When worn by the patient, the VertiGONE Goggle allows the primary care physician to accurately guide the patient through the movements of the Epley maneuver. The goggle also contains a feedback mechanism for self-guided Epley maneuvers so that a patient prone to recurrent BPPV can perform the maneuver at home. Since the process of using the VertiGONE Goggle starts with a primary care physician, the time a patient has to wait for an appointment to do the Epley maneuver significantly reduces. The VertiGONE Goggle also reduces the cost of treatment as there are fewer office visits required to perform the technique and the patient can use the goggle at home.

The overall goal of creating the VertiGONE Goggle is to increase patient access to rapid treatment for BPPV by enabling primary care practitioners to accurately perform the maneuver. This paradigm shift in the treatment of BPPV will result in reduced healthcare expenditures and most importantly, will largely eliminate unnecessary suffering in the BPPV patient population, as patients will no longer have to wait weeks or months for proper treatment.