Objective:

This study aims to see if using occipital nerve blocks (ONB) can increase neck range of motion (ROM) to help Epley maneuver and/or decrease residual cervicogenic vertigo post-Epley in benign paroxysmal positional vertigo (BPPV) patients with cervicalgia.

Background:

BPPV and cervicalgia are commonly seen in patients with dizziness/vertigo, especially in elderly populations. The Epley maneuver is used to treat BPPV, and ONBs can increase neck ROM in patients with cervicalgia, which may help the Epley maneuver and decrease residual dizziness from cervicogenic vertigo.

Design/Methods:

We conducted a retrospective chart review of patients who had an Epley and ONB in a single visit between 2021 and 2024. Patients either a) underwent two unsuccessful Epley trials, then had ONB and successful Epley, or b) patients had successful Epley in two trials then received the ONB for cervicalgia.

Results:

We identified 44 patients that meet the above criteria. The average age was 66.4 (38 female). 6 patients (14%) had unsuccessful Epley with two trials, ONB was administered, then a repeat Epley became successful due to increased neck ROM. The rest of these patients (86%) had successful Epley with one or two trials; then the ONB was given for their neck stiffness with limited ROM. 35 patients (80%) attended a follow up visit 4-12 weeks after treatment, and 33 patients (94%) had resolved their BPPV. 4 patients had unresolved cervicogenic vertigo, and 6 had central or peripheral vestibular dizziness.

Conclusions:

Our data suggests ONB can be helpful for BPPV treatment in patients with cervicalgia by either improving the success of the Epley maneuver and/or decreasing cervicogenic vertigo by improving neck ROM.