The Effect of Chewing Gum on Dizziness in Patients Diagnosed With Posterior Canal Benign Paroxysmal Positional Vertigo in the Emergency Department

Inclusion Criteria:

• Aged 18-65 years
• Duration of dizziness complaint less than 24 hours
• Posterior canal BPPV diagnosis confirmed by the emergency physician via the Dix-Hallpike test
• Intravenous administration of 50 mg dimenhydrinate in 100 cc 0.9% NaCl initiated by the responsible emergency physician
• Symptomatic dizziness with VAS ≥ 4
• Alert, cooperative, and able to chew gum
• Willingness to participate and provision of written informed consent

Exclusion Criteria:

• Findings suggestive of central vertigo (vertical nystagmus, diplopia, ataxia, hemiparesis, focal neurological deficit, etc.)
• Pregnancy
• Known gum intolerance, history of allergy to gum or its excipients, temporomandibular joint dysfunction, significant tooth loss, use of dentures or removable prosthetics that would prevent chewing
• Altered level of consciousness
• Central pathology detected on investigations performed during the visit
• Hemodynamic and/or respiratory instability
• Diagnosis other than posterior canal BPPV as the cause of vertigo
• Treatment other than pharmacological therapy planned or already administered by the responsible emergency physician
• Active vomiting at the time of enrollment
• Severe dizziness with VAS ≥ 8 (excluded due to high likelihood of requiring additional treatment, risk of protocol deviation, and safety concerns regarding gum chewing)
• Patients who initially consented but subsequently wish to withdraw from the study