Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: the role of subclinical BPPV

Mazzucco, Walter; Mazzola, S; Martines, Francesco

doi:10.14639/0392-100x-2247

Cited by 21 publications

(15 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cinnarizine, acting on the peripheral vestibular system, can selectively inhibit spasmogen-stimulated Ca 2+ influx and promote an anti-vasoconstrictor action [ 53 ] that consequently causes an increase in blood flow to the vestibular nuclei. This activity counters the insufficient cerebral blood circulation likely responsible for “vertiginous symptoms” such as dizziness, nausea, vomiting, and tinnitus [ 23 , 24 , 54 , 55 ]. Furthermore, dimenhydrinate, through the block of H1 receptors abundantly located throughout the central vestibular nuclear complex—including the medial vestibular nucleus—inhibits the spreading impulses at the medullar vestibular, which are closely associated with vegetative sensory regulation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms

Plescia

Salvago

Messina

et al. 2021

IJERPH

View full text Add to dashboard Cite

Vertigo is not itself a disease, but rather a symptom of various syndromes and disorders that jeopardize balance function, which is essential for daily activities. It is an abnormal sensation of motion that usually occurs in the absence of motion, or when a motion is sensed inaccurately. Due to the complexity of the etiopathogenesis of vertigo, many pharmacological treatments have been tested for efficacy on vertigo. Among these drugs, cinnarizine, usually given together with dimenhydrinate, appears to be the first-line pharmacotherapy for the management of vertigo and inner ear disorders. Based on these considerations, the present non-interventional study aimed to investigate the clinical efficacy and tolerability of a fixed combination of cinnarizine (20 mg) and dimenhydrinate (40 mg) in patients suffering from vertigo-related symptoms. To this end, we enrolled 120 adults—70 males, and 50 females—with an average age of 64 years. Before beginning pharmacological treatment, all patients were screened for the intensity of vertigo, dizziness, and concomitant symptoms through the Visual Scale of Dizziness Disorders and Dizziness Handicap Inventory scales. At the end of the anamnestic evaluation, patients received the fixed-dose combination of cinnarizine (20 mg) plus dimenhydrinate (40 mg) 3 times daily, for 60 days. The results of this study provide further insight regarding the efficacy of the fixed combination when used to reduce symptoms of vestibular vertigo of central and/or peripheral origin, after both the 15- and 60-day therapies. Independent of the type of vertigo, the fixed combination was able to reduce dizziness- and vertigo-associated symptoms in more than 75% of all patients treated, starting from 15 days of therapy, and improving 60 days after starting the therapy. Interestingly, we also found differences between male and female patients in the framework of the pharmacological effects of therapy. This study provides further details concerning the therapeutic efficacy of the fixed combination of cinnarizine and dimenhydrinate, and also focuses attention on the possibility that these drugs could act in a gender-specific manner, paving the way for further research.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms

Plescia

Salvago

Messina

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Although repositioning procedures are usually very effective in improving vertigo, some patients report, for a certain period afterward, imbalance without positional vertigo, named RD. The pathogenesis of the RD is still debated 19,20 . In most cases there is a spontaneous resolution in a variable time, from days to weeks 21 , which is also confirmed by our study.…”

Section: Discussionmentioning

confidence: 99%

Persistent postural perceptual dizziness following paroxysmal positional vertigo in migraine

Tropiano

Lacerenza

Agostini

et al. 2021

Acta Otorhinolaryngol Ital

View full text Add to dashboard Cite

Objective. This prospective study aimed to investigate the role of migraine in favouring the onset of persistent postural perceptual dizziness (PPPD) following paroxysmal positional vertigo (PPV). Methods. A group of patients who came to our attention suffering of PPV with or without migraine and/or vestibular migraine (VM) was examined. Three months after the resolution, an anamnestic research was conducted aimed at establishing whether any patientrelated dizziness could meet the diagnostic criteria for PPPD. Results. 12 of the 240 patients recruited met the diagnostic criteria for PPPD for an overall incidence of 5%, with 3 (1.85%) belonging to the non-migraine group and 9 (11.5%) to the migraine group. In the latter, 6 (28.6%) patients with VM and 3 (5.26%) without VM were affected. Conclusions.The study shows a significant increase of PPPD diagnosis in migraine compared to patients without migraine (p = 0.003). Within migraine there was a significant increase in those with VM compared to patients without VM (p = 0.0016). No difference emerged between patients without migraine and migraine patients without VM (p > 0.05).

show abstract

“…RD is considered a complex vestibular disorder and several hypotheses have been proposed to explain its pathophysiology [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Although theoretically valid, none of them has been supported by definitive data, nor do they exclude other causal factors that could play a role in the genesis of RD acting either independently or synergistically.…”

Section: Discussionmentioning

confidence: 99%

“…Several hypotheses have been proposed to explain the pathomechanism underlying residual symptoms after successful repositioning procedures. Possible explanations include either the persistence within the canal lumen of a too limited number of residual debris to provoke detectable positional nystagmus, the persistence of utricular dysfunction accompanying BPPV, and the occurrence of long-lasting central adaptation mechanisms [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. In previous research, the overall prevalence of RD ranges between 36.6% and 61% [ 10 ], and both vestibular rehabilitation and various drugs have been proposed to manage this condition [ 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Recovery of Regular Daily Physical Activities Prevents Residual Dizziness after Canalith Repositioning Procedures

Martellucci

Stolfa

Castellucci

et al. 2022

IJERPH

View full text Add to dashboard Cite

Objective: Residual dizziness is a disorder of unknown pathophysiology, which may occur after repositioning procedures for benign paroxysmal positional vertigo. This study evaluates the relationship between regular daily physical activity and the development of residual dizziness after treatment for benign paroxysmal positional vertigo. Study Design: Prospective observational cohort study. Setting: Academic university hospital. Methods: Seventy-one patients admitted with benign paroxysmal positional vertigo involving the posterior semicircular canal were managed with Epley’s procedure. Three days after successful treatment, the patients underwent a telephone interview to investigate vertigo relapse. If the patients no longer complained of vertigo, they were asked about symptoms consistent with residual dizziness. Subsequently, they were asked about the recovery of physical activities they regularly performed prior to the onset of vertigo. Results: Sixty-nine patients (age: 57.79 ± 15.05) were enrolled: five (7.24%) reported vertigo relapse whereas twenty-one of sixty-four non-relapsed patients (32.81%) reported residual dizziness. A significant difference in the incidence of residual dizziness was observed considering the patients’ age (p = 0.0003). Of the non-relapsed patients, 46 (71.88%) recovered their regular dynamic daily activities after treatment and 9 (19.57%) reported residual dizziness, while 12 of the 18 patients (66.67%) who did not resume daily activity reported residual symptoms (p = 0.0003). A logistic regression analysis showed a significant association between daily activity resumption and lack of residual dizziness (OR: 14.01, 95% CI limits 3.14–62.47; p = 0.001). Conclusions: Regardless of age, the resumption of regular daily physical activities is associated with a lack of residual dizziness.

show abstract

Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: the role of subclinical BPPV

Cited by 21 publications

References 27 publications

Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms

Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms

Persistent postural perceptual dizziness following paroxysmal positional vertigo in migraine

Recovery of Regular Daily Physical Activities Prevents Residual Dizziness after Canalith Repositioning Procedures

Contact Info

Product

Resources

About