Osteopenia and osteoporosis in idiopathic benign positional vertigo (original) (raw)
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Journal of Vestibular Research
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: p...
Makassar Dental Journal
Introduction: Benign paroxysmal positional vertigo (BPPV) is commonly found in older women; caused by the presence of otoconia in semicircular canals, which will stimulate the ampulla. Degeneration of otoconia and abnormal calcium metabolism could contribute to BPPV. This study aims to find a difference in serum calcium levels between idiopathic BPPV and non-BPPV vertigo patients. Methods: Cross-sectional study was held in Wahidin Sudirohusodo hospital in Makassar from August to October 2019. Subjects who fulfilled the criteria were divided into two groups (BPPV and non-BPPV). Venous blood was taken to obtain serum calcium levels. Statistical analysis was performed with SPSS software version 21. Chi-square and Mann-Whitney tests were used to determine the relationship between variables. Result: As many as 45 subjects were grouped into BPPV (n=30) and non-BPPV (n=15). Majority of subjects were female (n=30). Mean serum calcium level was significantly lower in BPPV group (8.51±0.67 vs...
International Archives of Otorhinolaryngology
Introduction Studies have found that elderly patients with benign paroxysmal positional vertigo (BPPV) may present low levels of vitamin D (25 (OH) D), changes in bone mineral density, and diabetes mellitus (DM). Objective: To investigate the possible association between BPPV, bone mineral density, hypovitaminosis D, 25 (OH) D and DM. Methods The sample consisted of 109 elderly subjects. The BPPV was verified by a standardized questionnaire and the Dix-Hallpike maneuver. Blood samples were collected for the investigation of 25 (OH) D serum levels. The bone mineral density was evaluated by means of a densitometer. Diabetes mellitus verification was performed using a self-reported questionnaire. Results Of the 109 participants, 17 had BPPV. There was a statistically significant difference between BPPV and gender (p = 0.027, phi = 0.222), with female representing 88.2% of those with BPPV. In the group with BPPV, there was a statistically significant difference for the amount of vitamin...
Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review
Journal of Clinical Medicine
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 o...
Auris Nasus Larynx, 2014
Primary objective of this study was to find a statistical link between the most worldwide comorbidities affecting the elderly population (hypertension, diabetes, osteoarthrosis, osteoporosis and depression) and recurrent episodes of BPPV. Secondary objective was defining possible ''groups of risk'' for people suffering recurrent positional vertigo related to the presence of a well documented comorbidity. Methods: This was an observational, cross-sectional, multicenter, spontaneous, non-pharmacological study. Thedataof1092patientssufferingBPPVevaluatedin11differentDepartmentsofOtolaryngology,Otoneurology and Neurology, referring Centers for positional vertigo evaluation, were retrospectively collected. Results: Regarding evaluated comorbidities (hypertension, diabetes, osteoarthrosis, osteoporosis and depression), data analysis showed the presence of at least one comorbid disorder in 216 subjects (19.8%) and 2 or more in 408 subjects (37.4%). Moreover there was a statistical significant difference between the number of comorbidities and the number of recurrences, otherwise said as comorbidity disorders increased the number of relapses increased too. Conclusion: The presence of a systemic disease may worsen the status of the posterior labyrinth causing a more frequent otolith detachment. This condition increases the risk for patients suffering BPPV to have recurrent episodes, even if correctly managed by repositioning maneuvers. The combination of two or more of aforementioned comorbidities further increases the risk of relapsing BPPV, worsened by the presence of osteoporosis. On the basis of this results it was possible to define ''groups of risk'' useful for predicting BPPV recurrence in patients with one or more comorbidity.
Association of Serum Calcium and Vitamin D with Benign Paroxysmal Positional Vertigo
International Archives of Otorhinolaryngology, 2021
Introduction Benign paroxysmal positional vertigo (BPPV) is one of the common disorders of the peripheral vestibular system. The prevalence of BPPV is found to be higher among middle-aged women. Objectives To estimate the serum levels of calcium and vitamin D in patients with BPPV, and to study their association. Methods The present is a hospital-based prospective case-control study. Venous blood samples of the 49 patients with BPPV and an equal number of age- and gender-matched individuals were recruited and submitted to an analysis of the serum levels of calcium and vitamin D. Results Among the cases, 67.3% were found to be females, and 32.7% were males. Most of the 30 cases (61.3%) were aged > 40 years. The mean age of the cases was 44.39 years. The mean serum level of vitamin D in the cases was of 21.26 ng/ml compared with 17.59 ng/ml in the controls. The mean serum level of calcium was of 9.33 mg/dl in the cases, compared with 8.95 mg/dl in the controls. There was no signifi...
Ear, Nose & Throat Journal, 2021
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 t...
Effect of vitamin D levels in benign paroxysmal positional vertigo
2021
BPPV is most commonly clinically encountered as 1 of 2 variants, BPPV of posterior semicircular canal (posterior canal BPPV) and BPPV of lateral semicircular canal (also known as horizontal canal BPPV). Back in 2003 Vibert et al suggested a connection between BPPV, osteoporosis and osteopenia. Even a beneficial therapeutic effect could be observed between BPPV and osteoporosis when treated with bisphosphonates in women. As a hypothesis, we suggested that there is a relation between insufficient vitamin D level and benign paroxysmal positional vertigo. We raised the possibility that patients with BPPV who had low vitamin D levels may benefit from supplementation and suggest further epidemiological investigations to determine the effect of correcting vitamin D deficiency on the recurrence of vertigo. It is well established that vitamin D and calcium are necessary for bone health. Bone mineralization and strength suffers in their absence. Vitamin D assists in the absorption of calcium....
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014
To compare the clinical characteristics of benign paroxysmal positional vertigo (BPPV) between the elderly and the younger patients. The medical records of BPPV patients with positive testing result on the Dix-Hallpike or supine roll test between January 2002 and December 2012 at Songklanagarind hospital, Thailand were retrospectively reviewed. Of the 951 BPPV patients, 595 patients were in the younger group (age < or =60-year-old, mean age = 46.9+/-8.9 years) and 356 patients were in the elderly group (age >60-year-old, mean age = 69.3+/-6. 7years). The most common etiology of BPPV was idiopathic. No significant difference was found regarding gender and semicircular canals that were involved in both groups. The most involved semicircular canal was the posterior canal. The most common described symptom of BPPV was vertigo. Patients in the elderly group were less likely to describe vertigo as the presenting symptom of BPPV compared to those in the younger group (OR = 0.22; 95% ...
Unrecognized benign paroxysmal positional vertigo in elderly patients
Otolaryngology–Head and Neck Surgery, 2000
Balance disorders in elderly patients are associated with an increased risk of falls but are often difficult to diagnose because of comorbid chronic medical problems. We performed a cross‐sectional study to determine the prevalence of unrecognized benign paroxysmal positional vertigo (BPPV) and associated lifestyle sequelae in a public, inner‐city geriatric population. Dizziness was found in 61% of patients, whereas balance disorders were found in 77% of patients. Nine percent were found to have unrecognized BPPV. Multivariate analysis demonstrated that the presence of a spinning sensation and the absence of a lightheadedness sensation predicted the presence of unrecognized BPPV. Patients with unrecognized BPPV were more likely to have reduced activities of daily living scores, to have sustained a fall in the previous 3 months, and to have depression. These data indicate that unrecognized BPPV is common within the elderly population and has associated morbidity. Further prospective ...