Co-existence of Benign Paroxysmal Positional Vertigo and Meniere's Syndrome.

Abstract

Recent studies indicate interrelation of benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD). These two entities may have different clinical characteristics. Five hundred thirty patients with BPPV evaluated between 2009-2015 were enrolled in the study. 351 patients who had no clear problem associated with BPPV (idiopathic) and 17 patients with MD were analyzed in detail. The age, sex, site of involvement, type of BPPV, symptom duration, and treatment outcome were compared. Meniere's disease + BPPV was more common in the female population (2/15; 7.5 v 127/224; 1.8, p<0.05). Comparative analysis of average age was not statistically significant (42.82±9.94 v. 40.29±1.65, p=0.601). There was no difference in right and left ear involvement between groups. Lateral canal involvement was more common in the BPPV + MD group (9/17; 53% v. 100/351; 28%, p<0.05). BPPV was ipsilateral to the ear with MD in 75% of patients and it was present before the diagnosis of BPPV in 82.3% of patients. Comparative analysis of cure rate between idiopathic BPPV and BPPV + MD after one session was significant (64.7% v 78%, p<0.05). Benign paroxysmal positional vertigo associated with MD presented a divergent picture. It was more frequent in females. Lateral canal involvement was higher. Patients had MD before the development of BPPV and they had prolonged symptoms, which raised a question of diagnostic delay since these two problems were in the same ear in majority of patients. Finally, relief of symptoms required more attempts of repositioning maneuvers.