Head-stabilized, nystagmus-based repositioning apparatus, system and methodology

• US 8,162,846 B2
• Filed: 06/29/2010
• Issued: 04/24/2012
• Est. Priority Date: 11/18/2002
• Status: Expired due to Fees

• Current Assignee: Vesticon-Bsi, LLC
• Original Assignee: Epley Research, LLC
• Inventors: Epley, John M.
• Primary Examiner(s): HOEKSTRA, JEFFREY GERBEN
• Application Number:
  US12/803,527
• Publication Number:
  US 20100331721A1
• Time in Patent Office: 665 Days
• Field of Search: 600/300, 600/301, 600/372, 600/382, 600/384, 600/393, 600/522, 600/552, 600/559, 600/560, 600/561, 600/587, 600/595, 600/558
• US Class Current: 600/559
• CPC Class Codes: A61B 3/113 for determining or recording eye movement
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1126 using a particular sensing technique
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/398 Electrooculography [EOG], e.g. detecting nystagmus; Electroretinography [ERG]
• CPC Class Codes: A61B 5/4023 Evaluating sense of balance
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4863 Measuring or inducing nystagmus
• CPC Class Codes: A61B 5/6814 Head
• CPC Class Codes: A61B 5/6831 Straps, bands or harnesses
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Structure and methodology involving mountable and head-wearable frame structure which is positionally stabilized, during use, relative a human subject'"'"'s head, and which carries a selection of positionally anchored data sensors, and stimuli deliverers, that are relevant to the diagnosis and treatment of vestibular disorders. Special configurations are provided for two types of stimulators, one for sound application and air-pressure modification, and the other for the introduction of fluids to the ear. Stabilization enables tight and accurate correlation of data which is quickly analyzable by a connected, properly algorithmed computer, which can also be used for feedback control in a designed “expert” system. The invention enables, among other things, practical and significant differentiation between physiological and pathological nystagmus.

Claims

1. A method of enabling assessment and/or treatment of vestibular-function in a human subject, comprising:

providing a goggle-like frame structure configured for securing to a subject'"'"'s head in a non-relative-motion condition therewith, wherein the frame structure includes an eye-enclosing, ambient light-excluding housing, and further includes one or more tensive bands extending from the housing and configured to securely grip a portion of the subject'"'"'s head;

providing one or more image-capture devices coupled in a non-relative-motion condition with the housing, wherein the one or more image-capture devices is/are configured to obtain, within a darkened environment of the housing, imagery of a visually-observable oculo-vestibular response to a vestibular response-evoking stimulus administered to the subject;

providing circuitry operably coupled with the one or more image-capture devices, the circuitry being configured to convert the imagery to computer-readable vestibular response data; and

providing a computing device specially configured with correlation instructions which, when executed by the computing device, correlate the vestibular response data with subject spatial orientation-indicating data and to display to a user a viewable representation of the correlated data via a display device operably coupled with the computing structure.

2. The method of claim 1, further comprising:

one or more subject spatial-orientation sensing devices configured to produce data indicating a spatial orientation of one or more of the subject'"'"'s semi-circular canals, wherein the spatial orientation temporally-corresponds to the administered stimulus.

3. The method of claim 2, wherein the one or more subject spatial-orientation sensing devices are selected from the group consisting of (a) a linear accelerometer, (b) an angular accelerometer, (c) an inclinometer, (d) a geographical direction indicating device and (e) a subject spatial-orientation repositioning device.

4. The method of claim 1, further comprising:

providing one or more vestibular-response stimulating devices likewise coupled with the frame structure in a condition of immobility relative thereto.

5. The method of claim 4, wherein the one or more vestibular-response stimulating devices are selected from the group consisting of (a) a sound deliverer, (b) an air pressure modifier configured to engage with the subject'"'"'s ear and affect an air pressure within the subject'"'"'s auditory canal, (c) a fluid-flow structure configured to engage with the subject'"'"'s ear and dispense a fluid into the subject'"'"'s auditory canal, (d) a light-emitting structure, (e) a visual image-presenting structure, (f) a galvanic stimulus structure, (g) a caloric stimulus structure, and (h) a vibration-generating structure.

6. The method of claim 1, wherein the viewable representation includes one or more selected from the group consisting of (a) a graphical representation of a spatial orientation of one or more of the subject'"'"'s semi-circular canals, (b) a graphical representation of a spatial orientation of the subject'"'"'s head, (c) a graphical representation of a spatial orientation of one or both of the subject'"'"'s eyes, (d) captured video imagery of one or both of the subject'"'"'s eyes (e) a graphical representation of a spatial orientation of a subject-repositioning structure with respect to which the subject'"'"'s head is held relatively immobile, and (f) a graphical tracing of vertical slow-phase nystagmus activity displayed perpendicularly relative to a temporally-corresponding graphical tracing of horizontal slow-phase nystagmus activity.

7. The method of claim 1, wherein the viewable representation includes a graphical depiction of movement of one or both of the subject'"'"'s eye, the depicted movement corresponding responsively to actual movement of the subject'"'"'s eye in one or both of a lineal axis and a rotational axis.

8. The method of claim 6, wherein movement of the one or more selected graphical representations viewably-depicted at the display device represents and corresponds responsively to a changed spatial orientation of the respective actual structure(s) represented by the one or more selected iconic representations.

9. The method of claim 1, wherein the viewable representation includes a graphical representation of one or more of the subject'"'"'s semi-circular canals, and further includes one or more graphical elements depicted as being associated with and movable along the graphical representation of the respective one or more semi-circular canals.

10. The method of claim 8, wherein the movement of the one or more graphical elements corresponds responsively to the administered vestibular response-evoking stimulus.

11. The method of claim 1, wherein the viewable representation includes an iconic representation of one or more of the subject'"'"'s semi-circular canals, and further comprising:

providing computer-executable orientation instructions at a memory medium operatively coupled with the computing device, wherein execution of the orientation instructions by the computing device enables a user to selectively alter a depicted orientation of one or more of the viewable representations displayed at the display device, and in response to the alteration, the orientation instructions further cause a responsive and corresponding repositioning of the frame structure.

12. The method of claim 4, further comprising:

providing computer-executable stimulus instructions at a memory medium operatively coupled with the computing device, wherein execution of the stimulus instructions by the computing device enables administering one or both of a user-selected and computer-selected vestibular response-evoking stimulus to the subject by one or more of the vestibular-response stimulating devices.

13. The method of claim 1, wherein the vestibular response-evoking stimulus comprises altering a spatial orientation of the subject'"'"'s semicircular canals relative to a previously existing spatial orientation thereof along one or more axes of movement.

14. The method of claim 1, wherein the viewable representation comprises a graphical representation of an actual spatial orientation of one or more of the subject'"'"'s semicircular canals, and wherein a change in the depicted spatial orientation corresponds to a change in the actual spatial orientation of the subject'"'"'s one or more semicircular canals.

15. The method of claim 1, further comprising:

providing computer-executable display control instructions at a memory medium operatively coupled with the computing device, wherein execution of the display control instructions by the computing device enables selection of a depicted graphical representation of one of the vestibular response data and the spatial orientation-indicating data, and wherein the selection causes the display device to graphically depict a temporally-correlated other of the vestibular response data and the spatial orientation-indicating data.

16. The method of claim 1, further comprising:

providing computer-executable diagnostic instructions at a memory medium operatively coupled with the computing device, wherein execution of the diagnostic instructions by the computing device enables one or both of identification and graphically-viewable indication at the display device of one or more semicircular canals from which an observed abnormal nystagmus response originated.

17. The method of claim 16, wherein the identification includes vector analysis of one or both of the vestibular response data and the spatial orientation-indicating data.

18. The method of claim 1, further comprising:

providing computer-executable expert algorithm instructions at a memory medium operatively coupled with the computing device, wherein execution of the expert algorithm instructions by the computing device enables the computing device to recommend and/or administer one or more vestibular response-evoking stimuli to a subject.

19. The method of claim 1, wherein the one or more image capture devices is configured as an infrared videography device.

20. The method of claim 2, wherein the one or more subject spatial-orientation sensing devices are coupled with the frame structure in a condition of immobility relative thereto and relative to each other.