Betahistine add-on therapy for treatment of subjects with posterior benign paroxysmal positional vertigo: a randomized controlled trial / Terapia adjuvante de betaistina para o tratamento de indivíduos com vertigem posicional paroxística benigna posterior: um ensaio clínico randomizado

Abstract Introduction Benign paroxysmal positional vertigo is a common vestibular disorder that accounts for one fifth of hospital admissions due to vertigo, although it is commonly undiagnosed. Objective To evaluate the effects of betahistine add-on therapy in the treatment of subjects with posterior benign paroxysmal positional vertigo. Methods This randomized controlled study was conducted in a population of 100 subjects with posterior benign paroxysmal positional vertigo. Subjects were divided into the Epley maneuver + betahistine group (group A) and Epley maneuver only (group B) group. Subjects were evaluated before and 1-week after the maneuver using a visual analog scale and dizziness handicap inventory Results One hundred subjects completed the study protocol. The Epley maneuver had an overall success rate of 95% (96% in group A; 94% in group B, p= 0.024). Groups A and B had similar baseline visual analog scale scores (6.98 ± 2.133 and 6.27 ± 2.148, respectively, p= 0.100). After treatment, the visual analog scale score was significantly lower in both groups, and was significantly lower in group A than group B (0.74 ± 0.853 vs. 1.92 ± 1.288, respectively, p= 0.000). The change in visual analog scale score after treatment compared to baseline was also significantly greater in group A than group B (6.24 ± 2.01 vs. 4.34 ± 2.32, respectively, p= 0.000). The baseline dizziness handicap inventory values were also similar in groups A and B (55.60 ± 22.732 vs. 45.59 ± 17.049, respectively, p= 0.028). After treatment, they were significantly lower in both groups. The change in score after treatment compared to baseline was also significantly greater in group A than group B (52.44 ± 21.42 vs. 35.71 ± 13.51, respectively, p= 0.000). Conclusion The Epley maneuver is effective for treatment of benign paroxysmal positional vertigo. Betahistine add-on treatment in posterior benign paroxysmal positional vertigo resulted in improvements in both visual analog scale score and dizziness handicap inventory.

Resumo Introdução A vertigem posicional paroxística benigna é um distúrbio vestibular comum, responsável por um quinto das internações hospitalares por vertigem, embora seja comumente não diagnosticada. Objetivo Avaliar os efeitos da terapia adjuvante com betaistina no tratamento de indivíduos com vertigem posicional paroxística benigna posterior. Método Este estudo randomizado controlado foi feito em uma população de 100 indivíduos com vertigem posicional paroxística benigna posterior. Os indivíduos foram divididos nos grupos: manobra de Epley + betaistina (grupo A) e manobra de Epley apenas (grupo B). Os indivíduos foram avaliados antes e uma semana após a manobra por meio da escala visual analógica EVA e do questionário dizziness handicap inventory. Resultados Cem indivíduos completaram o protocolo do estudo. A manobra de Epley demonstrou uma taxa de sucesso global de 95% (96% no grupo A; 94% no grupo B, p = 0,024). Os grupos A e B tiveram escores basais semelhantes na EVA (6,98 ± 2,133 e 6,27 ± 2,148, respectivamente, p = 0,100). Após o tratamento, o escore na EVA foi significantemente menor em ambos os grupos e foi menor no grupo A do que no grupo B (0,74 ± 0,853 vs. 1,92 ± 1,288, respectivamente, p = 0,000). A mudança no escore da EVA após o tratamento em comparação com a linha basal também foi significativamente maior no grupo A do que no grupo B (6,24 ± 2,01 vs. 4,34 ± 2,32, respectivamente, p = 0,000). Os valores basais no dizziness handicap inventory também foram semelhantes nos grupos A e B (55,60 ± 22,732 vs. 45,59 ± 17,049, respectivamente, p = 0,028). Após o tratamento, eles foram significantemente menores em ambos os grupos. A mudança no escore após o tratamento em comparação com a linha basal também foi significantemente maior no grupo A do que no grupo B (52,44 ± 21,42 vs. 35,71 ± 13,51, respectivamente, p = 0,000). Conclusão A manobra de Epley é eficaz no tratamento da vertigem posicional paroxística benigna. O tratamento complementar com betaistina na vertigem posicional paroxística benigna posterior resultou em melhoria tanto no escore da EVA quanto no do dizziness handicap inventory.

Clinical Observation on Effect ofSai-ErFormula in Treatment of Benign Paroxysmal Positional Vertigo / 世界科学技术-中医药现代化

This study was aimed to summarize the effect ofSai-Er Formula in treatment of benign paroxysmal positional vertigo (BPPV). A total of 62 BPPV outpatients were randomly divided into two groups, which were the group of Epley’s maneuver combined withSai-Er Formula and the group of Epley’s maneuver. Observation was made on the treatment efficacy and vertigo integral 10 days, 1 month and 3 months after treatment. The results showed that after 10-day treatment, the effective rate of the group of Epley’s maneuver combined withSai-Er Formula was significantly higher than that of the control group (P = 0.045). And after 10-day, 1-month, 3-month treatment, the improving degree of vertigo integral was better than that of the control group (P < 0.005). It was concluded thatSai-Er Formula can relieve the vertigo symptom of BPPV, and reduce its recurrence rate.

Epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo in young / 中国综合临床

Objective To analyze the efficacy of epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in young.Methods Two hundred and fifty-eight cases(age was 18-50 years old) with PC-BPPV were randomly divided into maneuver group(86 cases),betahistine group(86 cases) and vertigo calming group(86 cases).The maneuver group was treated by epley maneuver associated with placebo,2 pills per time,3 times daily for one month and follow up one month.The betahistine group and vertigo calming group were treated by epley maneuver with betahistine(12 mg/ time,Tid) or vertigo calming(2 piles/time,Tid),the same dose,period of treatment and follow-up as maneuver group.Results After one time treatment,199 cases were cured in 258 patients,including 68 cases in maneuver group,66 cases in betahistine group,65 cases in vertigo calming group,and the difference between groups was not statistically significant(x2 =0.308,P＞0.05).After treatments and followed up for one month,72 cases were cured,3 cases were effective,11 cases were invalid in maneuver group;74 cases were cured,3 cases were effective,9 cases were invalid in betahistine group;81 cases were cured,4 cases were effective,1 cases were invalid in vertigo calming group.Efficient of betahistine group,maneuver group and vertigo calming group were 89.5％,87.2％ and 98.8％,and the difference between maneuver group and betahistine group was not statistically significant(x2=58.65,P＞0.05),the difference of vertigo calming group between with other groups was statistically significant(P＜0.05).Conclusion The effects of vertigo calming in addition to Epley maneuver is significantly better than both Epley maneuver and Epley maneuver combined with betahistine in young PC-BPPV,while the effects of Epley maneuver combined with betahistine isn't better than Epley maneuver.

Modified Epley maneuver associated with betahistine for treating posterior semicircular canal benign paroxysmal positional vertigo / 中国基层医药

Objective To analyze the efficacy of modified epley maneuver associated with betahistine for treating posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods 78 cases with unilateral PC-BPPV were divided into complexed therapy group(39 cases)and control group(39 cases)randomly.The complexed therapy group was treated by modified epley maneuver associated with betahistine 6mg per time,3 times daily for successive 1 month.the control group was treated by modified epley maneuver only.Results 78 patients after first treatment,56 cases were cured,control group(28 patients),complexed therapy group(28 cases),no statistically significant difference between the two groups.After 1 month of treatment,the control group were cured 30 cases,effective 3 cases,invalid 6 cases;the complexed therapy group were cured 37 cases,effective 1 case,invalid 1 case;complexed therapy group,the cure rate was 94.9％,significantly higher than the 76.9％ of control group(x2=4.3365,P＜0.05).Conclusion The modified epley maneuver associated with betahistine is effective to treat PCBPPV,which is worth being promoted.

Canalith repositioning maneuver of benign paroxysmal positional vertigo / 临床神经病学杂志

Objective To investigate the therapeutic efficacy of the canalith repositioning maneuver to benign paroxysmal positional vertigo (BPPV). Methods Epley maneuver, Barbecue rotation and Semont maneuver were applied to twelve cases of BPPV. Results Positional vertigo in all subjects disappeared completely 48 hours later by treatment with manipulative reduction, and no obvious adverse reaction was found. There was no recurrence during a follow up from 3 to 11 months.Conclusion The canalith repositioning maneuver is effective, simple and safe for the patients with BPPV and may be recommended as the first-selected treatment modality.