Residual Dizziness after Physical Treatment for Benign Paroxysmal Positional Vertigo. A Review of Recent Literature

After successful physical maneuvers for BPPV, some patient refers a non-positional dizziness lasting several days. In our review we considered epidemiology of the disorder, proposed pathophysiological mechanisms and therapy. The duration of Residual Dizziness (RD) has been evaluated by different authors in a range varying from 2 days to 3 weeks. Among pathophysiological mechanisms, it has been considered the possibility of the persistence of a small amount of debris in the canal, the possibility that BPPV could be a more complex disorder implying a primitive utricular dysfunction, the coexistence of emotional factors, possible delaying central compensatory mechanisms. Finally, proposed drug therapy for the disorder has been reported, as well as our experience. Different drugs have been reported to be useful for RD, including betahistine and anxiolytics. We found that the combined therapy with cinnarizine and dimenhydrinate may be useful in reducing both the rate of patients with RD and the duration of RD.