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2. Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

Author

Giacinto Asprella Libonati, Antonello Leone, Salvatore Martellucci, Andrea Gallo, Roberto Albera, Sergio Lucisano, Maurizio Bavazzano, Giuseppe Chiarella, Pasquale Viola, Francesco Galletti, Francesco Freni, Francesco Ciodaro, Vincenzo Marcelli, Giuseppe Tortoriello, Leonardo Scotto di Santillo, Pasqualina Maria Picciotti, Jacopo Galli, Silvano Vitale, Nicola Quaranta, Giada Cavallaro, Paolo Gamba, Roberto Teggi, Iacopo Cangiano, Mario Faralli, Annalisa Barboni, Aldo Messina, and Giusi Graziano

Subjects
vitamin D, BPPV, high recurrence BPPV, BPPV relapses, LICA®, antioxidants, Otorhinolaryngology, RF1-547
Abstract

Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences. A total of 128 patients with high recurrence-BPPV were randomized in three arms: Arm 1 consisted of subjects with “insufficient” or “deficient” vitamin D blood levels, treated with daily oral supplementation of LICA®, vitamins of group B and vitamin D3 (800 UI), Arm 2 included BPPV subjects with “sufficient” vitamin D who did not receive any nutritional support, and Arm 3 included subjects with a “sufficient” serum concentration of vitamin D who received supplementation with a compound of LICA® and Curcumin. After six months of follow-up, a significant reduction of BPPV relapses compared to the baseline was found only in Arm 1 (−2.32, 95% CI: 3.41–1.62, p-value < 0.0001). Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV.

Published
2022
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3. Approach to residual dizziness after successfully treated benign paroxysmal positional vertigo: effect of a polyphenol compound supplementation

Author

Giacinto Asprella Libonati, Vincenzo Marcelli, Nicola Lombardo, Giuseppe Agus, Pasquale Viola, Roberto Albera, Giovanni Ralli, Roberto Teggi, Leonardo Scotto di Santillo, Augusto Pietro Casani, Luigi Califano, Giuseppe Chiarella, and Elena Navari

Subjects
medicine.medical_specialty, Benign paroxysmal positional vertigo, business.industry, Visual analogue scale, Nausea, Internal medicine, Posturography, medicine, Pharmacology (medical), medicine.symptom, medicine.disease, business, Postural control
Abstract

Purpose To assess if a polyphenol compound supplementation (Vertigoval®) could improve residual dizziness earlier after benign paroxysmal positional vertigo (BPPV) and relieve patients from this disabling symptomatology. Methods In this prospective, multicentric study, 127 patients were randomized in the treatment group (TG), who received a 60-day supplementation, while 131 patients were randomized in the control group (CG), who did not receive any medication. The dizziness handicap inventory (DHI) score, static posturography, and the visual analog scale (VAS) for both dizziness (D-VAS) and nausea/vomit (N/V-VAS) were used as measures of outcome at baseline and after 30 and 60 days. Patients were asked about efficacy and tolerance to the treatment. Side effects were examined. Results A statistically significant greater decrease was established in the TG for DHI, D-VAS, and N/V-VAS compared to the CG. On the other hand, static posturography did not show statistical differences between the two groups, though a better clinical improvement after 60-day supplementation was shown in the TG in comparison to the CG. We counted mild side effects in only 2 patients. Most patients reported an excellent or good efficacy and tolerance to the treatment. Conclusion Residual dizziness is a frequent condition of unknown origin that manifests as persistent disabling imbalance after successful repositioning maneuvers for BPPV. The decreasing postural control can affect the quality of life, contributing to falling and psychological problems. The supplementation with the polyphenol compound used in our study is safe, manageable, and appeared to be able to reduce subjective symptoms and improve instability earlier, decreasing the risk of potential complications.

Published
2019

4. Double-Blind Randomized Trial on the Efficacy of the Forced Prolonged Position for Treatment of Lateral Canal Benign Paroxysmal Positional Vertigo

Author

Daniele Nuti, Giampiero Neri, Paolo Vannucchi, Soumit Dasgupta, Augusto Pietro Casani, Vincenzo Marcelli, Luigi Califano, Lorenzo Salerni, Rudi Pecci, Ilaria Bindi, Marco Mandalà, Felice Scasso, Beatrice Giannoni, Mario Faralli, and Leonardo Scotto di Santillo

Subjects
Adult, Male, Benign paroxysmal positional vertigo, Supine position, Adolescent, Lateral canal, law.invention, Double blind, evidence based, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Double-Blind Method, law, semicircular canals, Medicine, Humans, Sham treatment, 030223 otorhinolaryngology, double-blind randomized trial, forced prolonged position maneuver, lateral canal, vestibular, Physical Therapy Modalities, Aged, Vestibular system, Aged, 80 and over, business.industry, Middle Aged, medicine.disease, Otorhinolaryngology, Anesthesia, Female, business, 030217 neurology & neurosurgery
Abstract

OBJECTIVES/HYPOTHESIS The need for class I and II studies on the efficacy of liberatory maneuvers in the treatment of lateral canal benign paroxysmal positional vertigo (LC-BPPV) motivated the present double-blind randomized trial on the short-term efficacy of the forced prolonged position (FPP). STUDY DESIGN Double-blind, randomized controlled trial. METHODS Two hundred twenty-one patients with unilateral LC-BPPV met the inclusion criteria for a multicentric study. Patients were randomly assigned to treatment by FPP (116 subjects) or sham treatment (105 subjects). Subjects were followed up at 24 hours with the supine roll test by blinded examiners. RESULTS Among the sample, 67.4% and 32.6% of the patients showed respectively geotropic and apogeotropic variant of LC-BPPV. At the 24-hour follow-up, the effectiveness of FFP compared to the sham maneuver was, respectively, 57.8% versus 12.4% (P

Published
2020

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