Prevention of residual dizziness after repositioning maneuvers for benign paroxysmal positional vertigo with a combination of cinnarizine and dimenhydrinate

Backgrounds: Benign paroxysmal positional vertigo is a frequent complaint provoked by the detachment of otoconia from the utricle and their entry in a semicircular canal. Treatment is based on repositioning maneuvers; nonetheless, after successful maneuvers, some people refer an increase of instability without positioning vertigo or residual dizziness (RD). Aims and Objectives: To decrease the number of cases of RD and duration of symptoms, different pharmacological therapies have been proposed. We assessed the efficacy of cinnarizine 20 mg and dimenhydrinate 40 mg twice a day for 1 week as treatment for RD. Materials and Methods: We compared the presence and duration of RD in a sample of 177 patients treated with the association of cinnarizine 20 mg and dimenhydrinate 40 mg twice a day for 1 week after successful repositioning maneuvers with a sample of 118 nontreated subjects. Results: No difference was seen in age, anxiety, duration of vertigo before treatment, and frequency of migraine between the two groups. Treated subjects had a lower rate of RD (30.5% vs. 14.1%, P = 0.0006) and duration of symptoms when present (5 ± 4 vs. 9 ± 7 days). Among treated subjects, 35 (19.8%) reported drowsiness and dry mouth at the beginning of treatment but without the need to discontinue therapy. Conclusions: Our data support the hypothesis that this combination is useful in the prevention and therapy of RD.