Abstract
It has been noted that benign paroxysmal positional vertigo (BPPV) may be associated with certain disorders and medical procedures. However, most studies to date were done in Europe, and epidemiological data on the United States (US) population are scarce. Gender-based information is even rarer. Furthermore, it is difficult to assess the relative prevalence of each type of association based solely on literature data, because different comorbidities were reported by various groups from different countries using different patient populations and possibly different inclusion/exclusion criteria. In this study, we surveyed and analyzed a large adult BPPV population (n = 1,360 surveyed, 227 completed, most of which were recurrent BPPV cases) from Omaha, NE, US, and its vicinity, all diagnosed at Boys Town National Research Hospital (BTNRH) over the past decade using established and consistent diagnostic criteria. In addition, we performed a retrospective analysis of patients’ diagnostic records (n = 1,377, with 1,360 adults and 17 children). The following comorbidities were found to be significantly more prevalent in the BPPV population when compared to the age- and gender-matched general population: ear/hearing problems, head injury, thyroid problems, allergies, high cholesterol, headaches, and numbness/paralysis. There were gender differences in the comorbidities. In addition, familial predisposition was fairly common among the participants. Thus, the data confirm some previously reported comorbidities, identify new ones (hearing loss, thyroid problems, high cholesterol, and numbness/paralysis), and suggest possible predisposing and triggering factors and events for BPPV.
Highlights
The peripheral vestibular organ consists of miniature inertial accelerometers: the semicircular canals (SCCs) specialized in detecting angular acceleration, and the otolithic organs in sensing linear acceleration including gravitational changes
Sudden hearing loss has commonly been reported in benign paroxysmal positional vertigo (BPPV) patients, ranging from 9–51% [24,25,26,27,45]; sudden hearing loss was rare among the Boys Town National Research Hospital (BTNRH) BPPV
Given that most of our BPPV patients are beyond middle age, we postulate that their hearing loss associated with BPPV is more likely caused by agerelated degeneration, rather than by immune or inflammatory responses proposed as the cause of some cases of sudden hearing loss
Summary
The peripheral vestibular organ consists of miniature inertial accelerometers: the semicircular canals (SCCs) specialized in detecting angular acceleration, and the otolithic organs in sensing linear acceleration including gravitational changes. In benign paroxysmal positional vertigo (BPPV), according to the accepted theory, utricular otoconia break apart from the mass and become dislocated into the semicircular canals. BPPV is the most common cause of vertigo. One third to one half of BPPV cases can be attributed to some type of head trauma/injury [1,2,3,4,5]. In the absence of head trauma or mechanical impact (e.g. surgical drilling) to cause otoconia dislocation, BPPV is categorized as unknown origin or idiopathic. In middle aged and older people, idiopathic BPPV cases are much more common. BPPV has been linked with reduced bone mineral density [32,33,34], suggesting that the spontaneous release of otoconia may parallel bone demineralization (for review see [30])
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