Objective: The purpose of this article is to describe BPPV in COVID-19 patients by discussing the possible mechanisms underlying the onset of this vertigo. Methods: We studied eight patients (4 F, 4 M, aged between 44 and 69 years) with COVID-19 infections complaining of vertigo. Patients were evaluated at the end of infection with an accurate clinical history, and the investigation of spontaneous, positional and positioning nystagmus. Results: The vestibular findings showed benign paroxysmal positional vertigo (BPPV) in all the patients. Three patients had a mild phenotype of the COVID infection, whereas five subjects were hospitalized for the COVID infection and in three cases intensive care was required. Vestibular evaluation showed an involvement of posterior semicircular canals in five patients and horizontal in three. Three patients were treated with the Epley maneuver, two with Semont, one with Lempert and two with Gufoni maneuvers. Conclusions: We hypothesize that BPPV in COVID-19 infections can be relate to drugs, prolonged bed rest and to direct damage by viral infection on the peripheral vestibular system and in particular on the otolitic membrane due to the cytopathic effect of the virus and to the inflammatory response. Studies on large series of patients are needed to confirm our preliminary observation and to better evaluate the pathophysiological mechanisms underlying BPPV in these patients.

In the pursuit of effective pain management, non-pharmacological interventions are gaining prominence within the medical community. Techniques like cognitive-behavioral therapy, physiotherapy, and relaxation methods are integral parts of modern treatment strategies. Among these, aromatherapy stands out for its drug-free approach and potential to utilize the body's sensory pathways for pain relief. Here we have introduced a Modified Olfactory Rehabilitation Protocol (mORP) and assessed its effectiveness in 34 chronic pain patients. Contrasted with a Control Group, which did not undergo olfactory rehabilitation, our novel protocol incorporates enhanced strategies to overcome conventional limitations. Initial results show significant pain reduction in the mORP group, supported by fMRI analyses revealing alterations in brain activation patterns associated with pain perception and emotional processing. These changes, particularly in olfactory-related regions, highlight mORP's ability to modulate pain pathways. These findings suggest mORP could revolutionize non-pharmacological pain therapy, emphasizing the potential of sensory-based approaches in reshaping chronic pain experiences. Further research is warranted to validate these findings and elucidate underlying mechanisms, guiding future advancements in sensory interventions against chronic pain.