Comparing the Effects of Epley Maneuver and Cinnarizine on Benign Positional Paroxysmal Vertigo; A Randomized Clinical Trial

Abstract

Background: The fastest and safest treatment method of BPPV is repositioning maneuvers. In Iran, this methods are not widely used, and many physicians use medical therapy, despite their side effects, for management of BPPV. Materials and Methods: In this randomized clinical trial patients with BPPV were randomly allocated to Epley repositioning maneuver or Cinnarizine (25mg every 8 hours) for two weeks. The patients were evaluated for symptoms using visual analogue scale (VAS) scoring system before intervention, first and second weeks after intervention. In the second and third visitd the results of hallpike test was recorded for both groups. Results: 43 patients with a mean age of 46.88±11.08 years in two Epley and Cinnarizine group underwent analysis. The mean VAS score for improvement of symptoms after intervention was 1.66±1.06 in Epley and 1.50±0.91 in Cinnarizine group (P=0.57). Conclusion: we found that there is no significant difference between Epley maneuver and Cinnarizine for treatment and controlling symptoms of BPPV. [GMJ.2019;8:e866]

Vestibular suppressants for benign paroxysmal positional vertigo: A systematic review and meta‐analysis of randomized controlled trials

“…The other trial using benzodiazepines used either diazepam 5 mg three times a day or lorazepam 1 mg three times a day 12 . Of the three studies that used antihistamines in their intervention arm, two used 25 mg cinnarizine every 8 h 35,36 and one used 10 mg flunarizine nightly 33 . One study, which was only included as part of the qualitative analysis, used the drug Ru‐Vert (25 mg pentylenetetrazol, 12.5 mg pheniramine maleate, 50 mg nicotine acid) 37 .…”

“…One study, which was only included as part of the qualitative analysis, used the drug Ru‐Vert (25 mg pentylenetetrazol, 12.5 mg pheniramine maleate, 50 mg nicotine acid) 37 . The duration of treatment varied from time in the ED, 34 1 week, 36 2 weeks, 35,37 4 weeks, 12 and 60 days 33 . One of the included studies had three arms: (i) antihistamine, (ii) no treatment, and (iii) CRM 33 .…”

“…33 Furthermore, only one study's intervention arm included both a CRM and a vestibular suppressant. 36 The follow-up period for five of the studies was 30 days or fewer, 12,[34][35][36][37] with one study following patients for 180 days. 33 All the included trials in the quantitative analysis were judged to be at probably high RoB (Table 2).…”

Role of Vestibular Suppressants (B. Histine, Cinnarizine, Meclizine) after Successful Epley’s Maneuvers in Benign Paroxysmal Positional Vertigo

“…As a result of the removal of all but the tiniest otoliths, positional nystagmus is no longer a concern following a successful Epley's maneuvers; instead, the patient may report feeling dizzy or as if they are floating. We believe vestibular suppressants may help with utricular dysfunction and with the elimination of any remaining, microscopic otoliths 17,25 . We assessed the rating based on a physical, emotional, and functional scale 26 .…”

“…The current investigation considered the cautions raised by Yadav H et al and evaluated potential confounding factors including patients' histories of head trauma and other inner ear diseases 16 . We compared medical therapy with Epley technique in two groups of patients, whereas Saeedi M et al, assessed the adjunctive efficacy of labyrinth sedatives 17 . Patients in the Sharif S et al research received medication for one week and were followed up with for another four weeks 18 .…”