Recurrence in Benign Paroxysmal Positional Vertigo: A Large, Single-Institution Study

Luryi, Alexander L.; Lawrence, Juliana; Bojrab, Dennis I.; LaRouere, Michael J.; Babu, Seilesh; Zappia, John J.; Sargent, Eric W.; Chan, E. C. S.; Naumann, Ilka C.; Hong, Robert S.; Schutt, Christopher A.

doi:10.1097/mao.0000000000001800

Cited by 41 publications

(62 citation statements)

References 35 publications

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“…We demonstrated the higher recurrence rate of BPPV among female patients and those with low BMD (osteopenia/osteoporosis), which were consistent with the previous results [10][11][12]23].…”

Section: Discussionsupporting

confidence: 92%

“…There have been studies with conflicting results regarding the recurrence of BPPV, since multiple factors including clinical settings, and even genetic backgrounds might have influence on the occurrence of BPPV [10][11][12]17]. For example, previous studies suggested that the patients with BPPV had higher frequency of vascular comorbidities (i.e., hypertension, diabetes mellitus, and hyperlipidemia), and these might also increase the risk of the recurrence in BPPV [11,17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, several studies reported the association of BPPV with inner ear diseases including vestibular neuritis, Menière's disease as well as vascular risk factors (e.g., hypertension, diabetes mellitus) [7]. Previous studies on the recurrence and long-term prognosis of BPPV conducted by domestic and international investigators have shown that similar factors that increase the risk of BPPV might be associated with the recurrence of BPPV as well [8][9][10][11][12]. However, the results were considerably inconsistent among studies and still need to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Recurrent Benign Paroxysmal Positional Vertigo: A Retrospective Cohort Study

Kim¹,

Cho²,

Lee³

et al. 2021

Res Vestib Sci

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Objectives: Benign paroxysmal positional vertigo (BPPV) is a potentially recurrent disease even after successful canalith repositioning maneuvers. However, the exact recurrence rate or any clinical factors affecting the recurrence of BPPV still need to be elucidated. Methods: We recruited patients diagnosed as BPPV in a tertiary hospital for 3 years. We retrospectively reviewed the clinical information of the patients including baseline demographics, comorbidities and predisposing factors through the electronic medical records. We performed a telephone survey or direct interview 3 to 6 years later from the initial diagnosis of BPPV was made. To determine the factors associated with the recurrence, we divided study population into two subgroups; 'recurrence group' vs. 'recurrence-free group.' Then, intergroup comparative analyses were performed. Results: Among 397 patients who were originally eligible for the study, we performed a telephone survey or direct interview in 289 patients (72.8%) to determine the recurrence of BPPV. The overall recurrence rate was 29.4% (85 of 289). Baseline demographics except female gender (p=0.014) were not different between subgroups. Neither clinical characteristics nor vascular comorbidities were associated with the recurrence. However, patients with low bone mineral density (BMD; T-score below -1, osteopenia/osteoporosis) showed significantly higher recurrence than those with normal BMD (40.6% vs. 0%, p=0.009). Conclusions: Female gender and low BMD (T-score below -1) were associated with the recurrence of BPPV in this study. Further researches in various clinical settings with larger sample size are warranted to identify the factors affecting the relapse of BPPV.

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“…We demonstrated the higher recurrence rate of BPPV among female patients and those with low BMD (osteopenia/osteoporosis), which were consistent with the previous results [10][11][12]23].…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Characteristics of Recurrent Benign Paroxysmal Positional Vertigo: A Retrospective Cohort Study

Kim¹,

Cho²,

Lee³

et al. 2021

Res Vestib Sci

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“…This relationship may be related to estrogen deficiency in postmenopausal women, as estrogen may promote the development of osteoporosis and even BPPV (18). In addition, women BPPV patients have a higher risk of recurrence than men (9,31). Therefore, further research between estrogen levels and BPPV may help early diagnosis and prevention of BPPV.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

et al. 2020

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Background and Purpose: The lifetime prevalence of benign paroxysmal positional vertigo (BPPV) is high, especially in the elderly. Patients with BPPV are more susceptible to ischemic stroke, dementia, and fractures, severely reducing quality of life of patients. Many studies have analyzed risk factors for the occurrence of BPPV. However, the results of these studies are not identical. We performed this meta-analysis to determine potential risk factors associated with the occurrence of BPPV. Methods: PubMed, EMBASE, and the Cochrane Library (January 2000 through March 2020) were systematically searched for eligible studies analyzing risk factors for the occurrence of BPPV. Reference lists of eligible studies were also reviewed. We selected observational studies in English with a control group and sufficient data. Pooled odds ratios (ORs) or the mean differences (MDs) and 95% confidence intervals (CIs) were calculated to measure the impacts of all potential risk factors. Heterogeneity among studies was evaluated using the Q-test and I 2 statistics. We used the randomeffect model or the fixed-effect model according to the heterogeneity among the included studies. Results: We eventually included 19 studies published between 2006 and 2019, including 2,618 patients with BPPV and 11,668 participants without BPPV in total. In this meta-analysis, the occurrence of BPPV was significantly associated with female gender (OR = 1.18; 95% CI, 1.05-1.32; P = 0.004), serum vitamin D level (MD = −2.12; 95% CI, −3.85 to −0.38; P = 0.02), osteoporosis (OR = 2.49; 95% CI, 1.39-4.46; P = 0.002), migraine (OR = 4.40; 95% CI, 2.67-7.25; P < 0.00001), head trauma (OR = 3.42; 95% CI, 1.21-9.70; P = 0.02), and total cholesterol level (MD = 0.32; 95% CI, 0.02-0.62; P = 0.03). Conclusion: Female gender, vitamin D deficiency, osteoporosis, migraine, head trauma, and high TC level were risk factors for the occurrence of BPPV. However, the effects of other risk factors on BPPV occurrence need further investigations.

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“…Thirty articles examined 14 risk factors for recurrence of BPPV and they included 12,585 participants ( Table 2 ). Twenty-three were retrospective studies [ 1 , 2 , 3 , 4 , 6 , 7 , 8 , 10 , 11 , 12 , 13 , 16 , 18 , 19 , 20 , 21 , 23 , 24 , 25 , 26 , 29 , 30 , 31 ] and seven were prospective cohort studies [ 5 , 14 , 15 , 17 , 22 , 27 , 28 ]. In all studies, the diagnosis of BPPV was established by positive positional tests (Dix-Hallpike, roll tests).…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review

Sfakianaki

Binos

Karkos

et al. 2021

JCM

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Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular dysfunctions encountered in clinical practice. Although the treatment of BPPV is relatively successful, many patients develop recurrence after treatment. Our purpose is to evaluate the mean recurrence rate and risk factors of BPPV after treatment. A review of the literature on the risk factors of BPPV recurrence was performed. A thorough search was conducted using electronic databases, namely Pubmed, CINAHL, Academic Search Complete and Scopus for studies published from 2000 to 2020. Thirty studies were included in this review with 13,358 participants. The recurrence rate of BPPV ranged from 13.7% to 48% for studies with follow-up <1 year, and from 13.3% to 65% for studies with follow-up ≥2 years. Pathophysiologic mechanisms and implication of each of the following risk factors in the recurrence of BPPV were described: advanced age, female gender, Meniere’s disease, trauma, osteopenia or osteoporosis, vitamin D deficiency, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, migraine, bilateral/multicanal BPPV, cervical osteoarthrosis and sleep disorders. Patients with hyperlipidemia and hypertension had the highest recurrence rates of BPPV, 67.80% and 55.89%, respectively, indicating that vascular comorbidities increase the risk of BPPV recurrence. In addition, more than half of patients (53.48%) with diabetes mellitus and BPPV experienced recurrence of BPPV. Knowledge and awareness of risk factors for recurrence of BPPV are essential for the assessment and long-term prognosis of patients. Identification of these relapse risk factors may enhance the ability of clinicians to accurately counsel patients regarding BPPV and associated comorbidities.

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Recurrence in Benign Paroxysmal Positional Vertigo: A Large, Single-Institution Study

Cited by 41 publications

References 35 publications

Clinical Characteristics of Recurrent Benign Paroxysmal Positional Vertigo: A Retrospective Cohort Study

Clinical Characteristics of Recurrent Benign Paroxysmal Positional Vertigo: A Retrospective Cohort Study

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review

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