Feasibility Assessment of Noninvasive Vestibular System Masking for Recalcitrant Pediatric Vertigo Management

In pediatric populations, untreated vertigo can be detrimental to overall health and quality of life. Current therapies for vestibular dysfunction include medical management and vestibular physical therapy. Noninvasive alternatives, such as vestibular stimulation, are gaining more attention. For this investigation, we trialed a novel study device utilizing noninvasive vestibular system masking (nVSM), which imparts low-frequency vibrations to the skull to alleviate common symptoms. In this pilot case series, we sought to determine the impact induced by this device as a treatment option.

Prospective pilot study at a tertiary, stand-alone children's hospital. Adolescents with persistent vertigo were tested in a computerized dynamic posturography (CDP) machine, which created real-world simulations to induce dizziness. CDP was completed twice during the testing appointment: once without the nVSM for a baseline level and then with the device. Symptom severity was assessed via the Pediatric Vestibular Symptom Questionnaire (PVSQ).

Five female patients with a mean age of 15.6 years were recruited into the trial. We observed a trend that might suggest differential responses across patient types, though a small sample size precludes any definitive conclusions. Mean PVSQ scores in the pre- and posttesting periods demonstrated decreased symptom severity (2.02-1.32). Although 2 participants reported slightly worsened scores, most expressed enthusiasm for continued access to the device.

In this uncontrolled pilot study, patients reported symptom reductions while using the device; however, controlled studies are needed to distinguish therapeutic effects from placebo responses. The device was well tolerated and may function as a low-risk, noninvasive alternative to current therapies. Future work will continue to evaluate the device's effectiveness. In this pilot study, for patients with no other options, the nVSM based on low-frequency inner ear stimulation has the potential to serve as a valuable and immediate treatment for symptom relief.