Smartphone-based nystagmus diagnostics: development of an innovative app for the targeted detection of vertigo

Abstract

Background In medicine, the symptom of dizziness is one of the most common multidisciplinary causes of emergency medical presentation. Attending physicians are often faced with difficult decisions when evaluating patients with dizziness. A rapid differential diagnostic decision must be made during the initial examination. The goal of this study, was to develop a smartphone-based app that can diagnose and qualify nystagmus. The app should enable differentiation between acute emergencies such as strokes ("central vertigo") and vestibular disorders ("peripheral vertigo") using and recognizing or analyzing the accompanying symptom "nystagmus". Materials and methods This prospective study was conducted at the Department of Otolaryngology, Head and Neck Surgery "Otto Körner", Rostock (Germany). The experimental study design consisted of two test runs and two control runs. In the two test runs, nystagmus was tracked and evaluated by caloric and optokinetic stimulation, respectively, through a custom-developed app. Sensitivity and correlation were calculated for the app's application performance and compared under different experimental conditions. Results The patient sample included twenty healthy participants with a mean age of 25.6 years (± 2.2 SD) who participated in the study. The overall sensitivity of detection of nystagmus averaged 82.14% in the optokinetic stimulation test trials. There is no correlation regarding specific subject data and sensitivity. Conclusions The results of our experimental validation study show that a smartphone-based nystagmus app is a useful tool for vertigo diagnosis. The results of our analyses show that it is possible to diagnose nystagmus and determine shape or direction with the app.

Smartphone-Assisted Medical Care for Vestibular Dysfunction as a Telehealth Strategy for Digital Therapy Beyond COVID-19: Scoping Review

“…Among the 20 studies that reported the use of a device or app, 2 were related to anamnesis and subjective symptoms [ 3 , 8 ], 12 were related to objective examination [ 8 - 19 ], 7 were related to remote diagnosis [ 9 , 11 , 15 , 16 , 18 , 20 ], and 7 were related to treatment and rehabilitation [ 20 - 26 ] ( Table 1 ).…”

“…Three papers used virtual reality (VR) for treatment with the Epley maneuver [ 21 ] and vestibular rehabilitation [ 23 , 26 ]. Eight papers included apps or devices with more than one category of medical act performed; all papers were about sequential acts [ 8 , 9 , 11 , 12 , 15 , 16 , 18 , 20 ].…”

“…Various types of tests are conducted in vertigo treatment, including balance function, nystagmus, and visual stimulation tests, such as SVV. The types of tests in the report included HIT [ 13 ], SVV [ 10 , 17 , 19 ], nystagmus [ 9 , 11 , 12 , 15 , 16 , 18 ], gait analysis [ 14 ], and hearing tests [ 8 ].…”

“…After the removal of duplicates, the titles and abstracts of 289 publications were screened. Based on the inclusion and exclusion criteria, the full texts of 38 publications were read, 18 publications were excluded, and 20 publications were included in this review (Figure 1, Multimedia Appendix 1 [3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]). Among the 20 studies that reported the use of a device or app, 2 were related to anamnesis and subjective symptoms [3,8], 12 were related to objective examination [8][9][10][11][12][13][14][15][16][17][18][19], 7 were related to remote diagnosis [9,11,15,16,18,20], and 7 were related to treatment and rehabilitation [20][21][22][23][24]…”

Künstliche Intelligenz in der Neurologie

“…KI-gestützte Analysen von vHIT, Videooculografie und Posturografie ermöglichen eine Unterteilung 69 . Als Weiterentwicklung daraus erfolgt die Erstellung von Apps, mit deren Hilfe in Akutsituationen durch klinische Tests oder Auswertung von Nystagmus-Formen Diagnosen verifiziert werden können 70 . Die Unterscheidung episodischer Schwindelanfälle in M. Mèniere oder eine vestibuläre Migräne kann in symptomfreien Intervallen schwierig sein.…”