Effect of triple therapy combined with betahistine in treating residual dizziness of patients with benign paroxysmal positional vertigo after repositioning

Objective To evaluate the effects of triple therapy combined with betahistine on cerebral blood circulation and cutaneous sympathetic response (SSR) in patients with residual dizziness after reposition of benign paroxysmal positional vertigo.

Methods A total of 196 patients with residual dizziness after reposition of benign paroxysmal positional vertigo were randomly divided into two groups, with 98 cases in each group. Control group was treated with betahistine, while experimental group was treated with betahistine and triple therapy (compound manipulation, transcranial magnetic stimulation and specific body position), and both groups were treated for 2 courses of treatment, with 7 days as a course of treatment. Efficacy, duration of residual dizziness, the scores of the Dizziness Handicap Inventory (DHI), the Visual Analogue Scale (VAS), the Activity Balance Confidence (ABC), the Hamilton Anxiety Scale (HAMA) and the Vestibular Symptom Index (VSI) before treatment and after the course of the treatment, SSR, and values of mean blood flow velocity (V_m) of cerebral vertebral artery (VA) and basilar artery (BA) were compared between the two groups.

Results The duration of residual dizziness in the experimental group was (10.25±3.74) days, which was significantly shorter than (15.26±2.98) days in the control group (P < 0.001); the total treatment effective rate of the experimental group was 93.88%, which was significantly higher than 79.59% of the control group (P < 0.05). At the end of the course, the scores of the three dimensions of the DHI in the experimental group were significantly lower than those in the control group (P < 0.05). At the end of the course, the VAS, the HAMA and the VSI scores in the experimental group were significantly lower than those in the control group, while the ABC score was significantly higher than that in the control group (P < 0.05). At the end of the course, the SSR amplitude value in the experimental group was significantly lower than that in the control group, while the SSR latency value was significantly higher than that in the control group (P < 0.05). At the end of the course, the values of V_m of VA and BA in the experimental group were significantly higher than those in the control group (P < 0.05).

Conclusion The combination of triple therapy and betahistine has a definite therapeutic effect on residual dizziness after reposition of benign paroxysmal positional vertigo, which can alleviate dizziness and vestibular symptoms, enhance activity balance confidence, relieve anxiety degree, and improve SSR and cerebral blood circulation.