Role Of Vitamin D Supplementation Along with Betahistine Alone in Patients of Benign Paroxysmal Positional Vertigo: A One Year Randomized Controlled Trial

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) poses a significant public health concern, affecting approximately 10% of the general population. Although considered benign, BPPV profoundly impacts quality of life. Current therapeutic maneuvers primarily focus on physical repositioning techniques, prompting exploration into pharmacological adjuncts. Vitamin D's role in calcium homeostasis and inner ear function, coupled with Betahistine's vasodilatory effects, led to the investigation of their combined efficacy in BPPV management. Materials and Methods: A one-year randomized controlled trial, enrolled 120 BPPV patients, aged 18-65 years. Participants were randomly assigned to Group A (Vitamin D supplementation + Betahistine) or Group B (Betahistine alone). Outcome measures included vertigo episode reduction, balance improvement, quality of life enhancement, and recurrence rates. Statistical analyses employed descriptive statistics, t-tests, chi-square tests, and Kaplan-Meier survival analysis. Results: Group A demonstrated significant reductions in vertigo frequency and intensity at 3, 6, and 12 months compared to Group B (p-values: 0.012, 0.035, 0.021, respectively). Improvements in balance were consistently notable in Group A at 3, 6, and 12 months (p-values: 0.045, 0.028, 0.061, respectively). Adverse events were minimal, with no significant differences between groups. Survival analysis indicated a prolonged time to recurrence in Group A (p=0.034). Conclusion: The combined intervention of Vitamin D supplementation and Betahistine demonstrated superior efficacy in reducing vertigo symptoms, improving balance, and extending the time to recurrence in BPPV patients over one year. Optimal Vitamin D levels further enhanced treatment response. While acknowledging study limitations, this research suggests a promising avenue for BPPV management, potentially influencing future clinical practices.