Analysis of Bone Mineral Density and Bithermal Caloric Test Results in Unilateral Idiopathic Benign Paroxysmal Positional Vertigo Patients

Abstract

ObjectiveBenign paroxysmal positional vertigo (BPPV) is the most frequently diagnosed type of peripheral vestibular vertigo. Studies have reported a possible association between BPPV and osteoporosis; however, there is still a lack of evidence. This study aimed to investigate the characteristics of bone mineral density (BMD) and bithermal caloric test results in patients with unilateral posterior canal idiopathic benign paroxysmal positional vertigo (pc-iBPPV).MethodsBMD was measured in 65pc-iBPPV menopausal female patients and 65 healthy controls using dual-energy xray absorptiometry and then compared the T-score of BMD between the two groups. The bithermal caloric test was also performed with video nystagmography and the relationship between canal paresis, directional preponderance, T-score, and recurrence were analyzed.ResultsLower T-scores were observed in pc-iBPPV patients compared with the normal subjects. Among 65 pc-iBPPV patients, free recurrence was observed in 38 (58.5%), single recurrence was noted in 14 (21.5%), and multiple recurrences were seen in 13 (20%) patients. The proportion of positive T-score and CP value increased with the pc-BPPV recurrence frequency. Statistically, a significant difference was found only in T-score, indicating that recurrence was raised with a decrement of T-score. The proportion of positive CP values tended to increase as BMD decreased.ConclusionThe decrement of BMD might be one of the pathogeneses in patients with unilateral pc-iBPPV and associated with multiple recurrences. Moreover, positive CP value cannot be regarded as a predictive factor for recurrence; however, there is a clear association between CP and BMD.

Spontaneous Nystagmus in Patients With Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

“…These results imply that the side of CP, if abnormal, in bithermal caloric test may indicate the affected side of PSCC BPPV, and further investigation is required to draw a conclusion on this. Jiang et al 39 reported that an abnormal caloric CP was observed in 52% of patients with PSCC BPPV, and the proportion of an abnormal caloric CP was correlated with the recurrence frequency of PSCC BPPV.…”

The role of electrocochleography and the caloric test in predicting short-term recurrence of benign paroxysmal positional vertigo

“…Bi et al ( 16 ) also found that the recurrence rate of BPPV patients with abnormal caloric test results was higher than that of patients with normal caloric test results. Abnormalities in caloric test results are rather frequent in patients with BPPV and require repeated treatment ( 17 – 19 ). The caloric test mostly assesses the function of the horizontal semicircular canal.…”