Monthly and seasonal variations in benign paroxysmal positional vertigo

2021 ◽  
pp. 1-7
Author(s):  
Junhui Jeong ◽  
Tae Seong Eo ◽  
Jangwon Oh ◽  
Hyang Ae Shin ◽  
Hyo Jin Chung ◽  
...  

BACKGROUND: Several studies on seasonal variation in benign paroxysmal positional vertigo (BPPV) have been reported. However, the association between season and BPPV remains controversial; thus, further study is required. OBJECTIVE: We analyzed patients with BPPV to evaluate monthly and seasonal variations. METHODS: Patients with BPPV seen between 2013 and 2017 were retrospectively enrolled in this study. Differences among the months and seasons of BPPV visits were analyzed. Patients were divided into two groups according to age (65 years or older and younger than 65 years) and sex, respectively, and the differences were analyzed in each group. RESULTS: There was no significant difference in the monthly or seasonal distribution of BPPV in the 1,216 patients. There was also no significant difference in the monthly or seasonal distribution in the older and younger groups or in male and female patients. CONCLUSIONS: There was no significant difference in the monthly or seasonal distribution of patients with BPPV. Additional studies on seasonal variation in BPPV are required in terms of not only vitamin D levels but also other associated factors.

2021 ◽  
pp. 014556132110085
Author(s):  
Kanokporn Sarsitthithum ◽  
Tosapohn Wisupagan ◽  
Sivaporn Kiatthanabumrung ◽  
Chanchai Jariengprasert

Objective: This study aimed to evaluate the association between serum vitamin D levels and benign paroxysmal positional vertigo (BPPV). Participants and Methods: This prospective study consisted of 137 participants. There were 69 participants in the BPPV group compared with 68 healthy participants. Blood samples from both groups were collected from all participants to assess serum vitamin D levels. Results: No significant difference in demographic data between BPPV and control groups. The results showed that the mean serum vitamin D levels in the BPPV group was lower than that of the control group ( P value = .001). Among BPPV participants, there was no statistically significant difference between mean serum vitamin D levels of participants with recurrent BPPV, and that of newly diagnosed BPPV participants ( P value = .313). Conclusion: A statistically significant association between lower mean serum vitamin D levels in the BPPV group compared with that of the control group. Therefore, low serum vitamin D levels may be one of the risk factors for BPPV.


2021 ◽  
pp. 014556132198945
Author(s):  
Hakkı Caner Inan ◽  
Cuma Mertoğlu ◽  
Zülküf Burak Erdur

Objective: Benign paroxysmal positional vertigo (BPPV) is characterized by recurrent attacks of vertigo caused by head movements. It occurs as a result of otoconia falling into the semicircular canal. Calcium and 25 hydroxyvitamin D [25(OH)D] metabolism in the inner ear play an important role in otoconia formation and degeneration. Our aim in this study was to investigate the relationship between 25(OH)D levels and BPPV. Methods: This retrospective, case–controlled study included 52 patients with posterior canal BPPV and 52 controls aged 18 to 80 years. Age, sex, serum calcium, corrected calcium, and 25(OH)D levels of the BPPV and control group were compared. Results: Twenty-three of the patients were male (44.2%) and 29 were female (55.8%). The average age was 55.6 years. The 25(OH)D level was 15.3 ng/mL in the BPPV group and 20.2 ng/mL in controls. There was no significant difference in 25(OH)D and albumin-corrected calcium values ( P = .394; P = .084, respectively). In 80.7% of the BPPV group and 61.5% of the controls, 25(OH)D levels were 20 ng/mL and below. 25 hydroxyvitamin D deficiency was found statistically significantly more frequently in patients with BPPV ( P = .030). Conclusion: In our study, serum 25(OH)D levels were found to be lower in patients with BPPV, and the rate of vitamin D deficiency was higher in these patients. Based on these results, it is recommended to examine the 25(OH)D levels of patients with BPPV at the time of diagnosis.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Liang Shu ◽  
Jing Wu ◽  
Chun-Yan Jiang ◽  
Xu-Hong Sun ◽  
Hui Pan ◽  
...  

Abstract Seasonal variation of benign paroxysmal positional vertigo (BPPV) occurrence has been reported in recent years. Whether the seasonality of BPPV also exists in Chinese patients and whether it correlates with serum vitamin D levels is unexplored. We retrospectively analyzed the data of 1269 new-onset idiopathic BPPV patients registered in our vertigo outpatient clinic over a six-year period. Additionally, serum 25-hydroxyvitamin D levels during this period were measured in 877 patients by chemiluminescence immunoassay. We delineated the changing trend of the monthly BPPV patient numbers and serum 25-hydroxyvitamin D levels, and the correlation between them was explored. December to next March is the top 4 months with higher BPPV patient numbers. The median BPPV patient numbers in winter group were higher than those in summer group (20 vs. 16 patients, p < 0.05). Median 25-hydroxyvitamin D levels in winter group were much lower than those in summer group (16.3 vs. 20.8 ng/ml, p < 0.001) and autumn group (16.3 vs. 19.3 ng/ml, p < 0.05). A moderate negative correlation was observed between median serum 25-hydroxyvitamin D levels and BPPV patient numbers each month. The onset of BPPV also shows a seasonal fluctuation in Chinese patients. This phenomenon may be related to serum vitamin D levels.


2020 ◽  
Vol 30 (6) ◽  
pp. 375-382
Author(s):  
Andrea Melis ◽  
Davide Rizzo ◽  
Roberto Gallus ◽  
Maria Eleonora Leo ◽  
Nicola Turra ◽  
...  

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) has a reported recurrence ranging from 26.8 to 50%. Osteoporosis and Vitamin D deficiency seems to have an impact on recurrence of BPPV. OBJECTIVE: to evaluate the impact of osteoporosis and Vitamin D deficiency on recurrence of BPPV. METHODS: 73 consecutive patients were divided in two groups according to the presence (group 1) or absence (group 0) of a recurrent episode. BMD, femoral and lumbar T-scores and Vitamin D levels were recorded. Statistical analysis was performed to investigate correlations. RESULTS: patients in group 1 had statistically significant lower values of both femoral (–1,62±1,06 vs. –0,53±1,51; p = 0,001), lumbar T-score (–2,10±1,19 vs –0, 53±1.51, p = 0.001) and Vitamin D (19.53±15.33). The values of femoral T-score and Vitamin D could be combined in a model able to properly classify 65.8% of the cases (p = 0.002) as isolated or recurrent BPPV, with high accuracy (AUC 0.710 [0.590 –0.830]). CONCLUSION: present data show a probable correlation between osteoporosis and Vitamin D with recurrent BPPV.


2013 ◽  
Vol 24 (07) ◽  
pp. 600-606 ◽  
Author(s):  
Alexandra C. Huebner ◽  
Susan R. Lytle ◽  
Steven M. Doettl ◽  
Patrick N. Plyler ◽  
James T. Thelin

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults and is a result of otolithic particles or debris that become free floating within a semicircular canal or adhere to the cupula. Characteristics of BPPV include brief episodes of latent onset vertigo that occur with changes in head position, transient rotary nystagmus beating toward the dependent ear, and reversed nystagmus upon sitting up. Both the vertigo and nystagmus fatigue quickly while maintaining the same head position. The BPPV may be classified as objective or subjective. Objective BPPV presents all the aforementioned symptoms whereas subjective BPPV presents all the symptoms without nystagmus. The accepted method of treatment for objective BPPV is canalith repositioning maneuvers (CRM); however, CRM are not traditionally used as the method of treatment for cases of subjective BPPV. Purpose: The purpose of the study was to determine if the subjective report of dizziness using the Dizziness Handicap Inventory (DHI) was different in patients with objective and subjective BPPV and to determine if the two groups showed similar improvements in perceived dizziness handicap following CRM treatment. Research Design: The present study utilized a retrospective, repeated measures design. Study Sample: Sixty-three adults with BPPV that were given the DHI both before and after CRM treatment. Data Collection and Analysis: Pre and post DHI results were analyzed for participants with objective versus subjective BPPV. A five-question DHI subscale was also analyzed between the groups. Results: A significant difference was noted between initial and posttreatment DHI scores for patients in both the subjective and objective groups when using the full-scale and subscale DHI. No significant difference was noted between groups for their initial or posttreatment DHI scores. The two groups also did not differ significantly in their initial or posttreatment DHI subscale scores. Conclusions: The results of the study indicated that individuals with both objective and subjective BPPV demonstrated significant improvement in DHI scores following CRM treatment. Additionally, there was no difference in DHI improvement for the subjective versus objective group suggesting CRM are effective for both subjective BPPV and objective BPPV. This improvement in DHI scores was also noted in the five-question DHI subscale with no significant difference noted between groups. These findings combined with previous studies suggest the presence or absence of nystagmus during Dix-Hallpike maneuvers is not related to the effectiveness of treatment using CRM.


Author(s):  
Shweta Sawant ◽  
Taranath Nandini ◽  
Rajashree Partabad

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is a common cause of disabling vertigo with a high rate of recurrence. BPPV is the most common cause of neurotological disorder. It is caused by dislodged otoconia which fall from the utricular macula and float into the semicircular canals there by making them sensitive to gravity. It has been shown that elderly people may suffer from unrecognized, chronic BPPV. Patients with unrecognized BPPV were more likely to have reduced activity of daily living scores, to have sustained a fall in the previous 3 months and to have depression.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 100 patients with clinical diagnosis of BPPV visiting Navodaya medical college and hospital between June 2019 to May 2020 were included in the study.</p><p class="abstract"><strong>Results:</strong> Patients taking both vitamin D supplementation and rehabilitation therapy improved better than patients taking rehabilitation therapy alone.</p><p class="abstract"><strong>Conclusions:</strong> Both rehabilitation therapy and supplementation of vitamin D is helpful in patients with vitamin D deficient BPPV patients.</p>


2019 ◽  
Vol 129 (5) ◽  
pp. 434-440
Author(s):  
Mir Mohammad Jalali ◽  
Hooshang Gerami ◽  
Alia Saberi ◽  
Siavash Razaghi

Objectives: The aim of this study was to compare the effects of betahistine with dimenhydrinate on the resolution of residual dizziness (RD) of patients with benign paroxysmal positional vertigo (BPPV) after successful Epley maneuver. Methods: In this double-blind, randomized clinical trial, patients with posterior semicircular canal type of BPPV were included. After execution of the Epley maneuver, patients were assigned randomly to one group for 1 week: betahistine, dimenhydrinate or placebo. The primary outcomes were scores of the Dizziness Handicap Inventory (DHI) and the modified Berg balance scale (mBBS). All patients were asked to describe the characteristics of their subjective residual symptoms. Binary logistic regression analysis was performed to examine the predictors of improved RD. All analyses were conducted using SPSS 19.0. Results: In total, 117 patients (age range: 20-65 years) participated in this study. After the Epley maneuver, 88 participants had RD. After the intervention, 38 patients exhibited an improved RD. Less than 50% of participants in the three groups showed mild to moderate dizziness handicap. However, there was no significant difference between mBBS scores of groups before or after the intervention. Logistic regression was shown that patients with receiving betahistine were 3.18 times more likely to have no RD than the placebo group. Increasing age was associated with a decreased likelihood of improving RD ( P = .05). Conclusion: The analysis of data showed that the use of betahistine had more effect on improving RD symptoms. We recommended future studies using objective indicators of residual dizziness.


2016 ◽  
Vol 27 (2) ◽  
pp. 23-27
Author(s):  
Abul Mansur Md Rezaul Karim ◽  
Md Hasanuzzaman ◽  
Mohammed Abu Yusuf Chowdhury ◽  
Md Abu Tayeb

Benign paroxysmal positional vertigo (BPPV) is paroxysms of vertigo occurring with certain head movements, typically looking up or turning over in bed comprising about 20% of Dizziness cases. This study was carried out to evaluate the Efficacy of canalith repositioning procedure(CRP) in BPPV. A randomized clinical trial including 80 patients with BPPV was performed Medicine & Neurology Outpatient Department, Chittagong Medical College Hospital. The patients were randomly divided into two groups. Group A treated by anti-vertigo drug and CRP, Group B treated by anti-vertigo drug alone. All patients were followed up in hospital at one week after & 4 weeks. The rates of effectiveness of CRP treatment and the control treatment for were 86.8% and 59.4%, respectively. There was a significant difference (27.4%) in the outcomes of the CRP & control groups (P <.05). Mean total drug use for the group A was 10 ± 1, whereas it was 30 ± 1.5 for group B, mean difference = 20 (P < .001, highly Significant). At 4 Weeks, subjective improvement and symptom free occurred in 94.7% patients in group A and 73% patients in group B (difference21.7%). Complications in the CRP group were observed in 10.6% of the patients. This study demonstrated that canalith repositioning procedure (CRP) was effective in the treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery & low drug dependence. Complications of CRP were limited to 10.6% of patients.Medicine Today 2015 Vol.27(2): 23-27


2014 ◽  
Vol 151 (5) ◽  
pp. 740-745 ◽  
Author(s):  
Ellis S. van der Scheer-Horst ◽  
Peter Paul G. van Benthem ◽  
Tjasse D. Bruintjes ◽  
Roeland B. van Leeuwen ◽  
Hester J. van der Zaag-Loonen

Objective To systematically review the evidence on the effectiveness of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. Data Sources A literature search was performed in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE databases. Review Methods A comprehensive search was performed up to July 2013. Two authors independently scanned the search results to identify randomized controlled trials of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. We included trials that were available in the English language and did not apply publication year or publication status restrictions. Studies were methodologically assessed using the Cochrane risk of bias tool. Primary outcome was the effect on vertigo attacks and balance. Results Of 76 identified trials, only 2 trials fulfilled our inclusion criteria and were included in this review, involving 106 patients. One study was methodologically weak, the other strong. The studies differed in type of intervention, type of outcome, and follow-up time. Both studies reported no significant difference in the vertigo intensity between groups. A small effect was found on balance. Conclusion Two level II studies in benign paroxysmal positional vertigo showed no effect of vestibular rehabilitation in addition to a canalith repositioning maneuver on vertigo intensity and a small, beneficial effect on balance. We therefore conclude that there is no evidence for an effect of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo.


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