A simple maneuver allows to solve the symptoms of the most common type of vertigo at primary care

IDIAPJGol launches a crowdfunding campaign to raise funds to finance the development of an app that will facilitate the diagnosis and treatment of benign paroxysmal positional vertigo, which affects more than 100,000 people each year in Catalonia

Metge realitzant la maniobra d'Epley a la consulta

More than half of the people who consult doctors at the primary care centres with symptoms of dizziness suffer from vertigo, a disabling disease that has a strong impact on the quality of life of patients. Most cases are benign paroxysmal positional vertigo, a condition that can be diagnosed and treated in less than five minutes in primary care consulting and emergency rooms with a few simple manoeuvres performed by the family doctors.

It is estimated that this benign variety of vertigo affects around 1.6 % of the population, which represents more than 100,000 people in Catalonia. This means that, on average, each family doctor sees one case in their office each week.

Although professionals have more and more information about this type of vertigo and how it can be addressed, there are still patients who spend months until they receive a diagnosis and find a professional who knows how to perform the manoeuvre.

Benign positional vertigo cannot be diagnosed through x-rays, MRIs, CT scans or tests, and the medications indicated for other varieties of vertigo are not effective in treating it.

Epley manoeuvre

The diagnosis of benign paroxysmal positional vertigo is made with the so-called Dix-Hallpike manoeuvre and the treatment is carried out with the Epley manoeuvre.

More than five years ago, researchers from the Institut d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol) published the results of a clinical trial that demonstrated that a single session of this last technique was effective in reducing symptoms and the perception of severity among patients. Since then, hundreds of family doctors have been trained in performing the Epley manoeuvre, through courses organized by the Catalan Ministry of Health and the Catalan Society of Family and Community Medicine (CAMFiC).

The effectiveness of the Epley manoeuvre is 70 % the first time it is performed and reaches 90 % the second time, which is carried out after a few days. Treated people recover between 24 and 48 hours after the intervention, but in many cases the improvement is immediate, and patients leave the consultation fully recovered.

Crowdfunding campaign

Although knowledge has increased considerably in recent years, neither the Dix-Hallpike nor the Epley manoeuvre are still routinely performed in family medicine offices.

The research group on the approach to vertigo in Primary Care (VERTAP) of the IDIAPJGol wants to develop a mobile application, called Nystavert, that will improve the training of these two techniques among professionals, as well as identify the characteristic eye movements of people affected by benign paroxysmal positional vertigo (nystagmus).

Nystavert includes a tutorial with the manoeuvres to perform in each case and a device that records eye movements on video with a mobile phone. This allows to view them later or consult with other professionals in case of doubt. With this approach, patients would be diagnosed at the first contact with the health system and their problem could be solved in just one or two visits.

To finance this application, IDIAPJGol has launched a fundraising campaign (crowdfunding) through the migranodearena platform.

The principal investigator of VERTAP, José Luis Ballvé, who is a family doctor at the CAP La Florida in Hospitalet de Llobregat (Barcelona), of the Catalan Institute of Health, highlights that “Nystavert will be a highly effective solution for the majority of primary care and emergency doctors, as well as other specialties, may be able to diagnose and treat benign paroxysmal positional vertigo and radically improve the quality of life of affected people.”

Vertigo Day

On April 22, World Vertigo Day is celebrated, an occasion to raise awareness about a highly disabling disease, which causes the perception that everything around the affected person revolves, and has a feeling of imbalance, dizziness and, often, nausea. The disease has a very negative impact on the daily lives of people who suffer from it.

Up to 30 % of the population will suffer from some episode of vertigo during their lifetime. It is more common among women than men and can appear at any age, although the incidence increases with age.