Risk factors of vestibular disorders in patients with metabolic disorders in the bone

Abstract

Actuality: Vestibular disorders of central and peripheral origin are often observed in patients with impaired bone mineral metabolism. Despite the benign nature, they cause significant disturbances in social life. Aim: study clinical and laboratory parameters and vestibular disorders in patients with different forms of benign paroxysmal positional vertigo (BPPV), related to degenerative-dystrophic changes of the musculoskeletal system and identify ways to further correct them. Materials and methods: We have studied 60 patients with BPPV. All patients underwent bone densitometry, examined the loss of bone strength of the spine and hip joint, vestibulometric study. Determined the value of mineral metabolism: the content of calcium and vitamin D in serum. To verify BPPV and its type, patients underwent posit ional tests. Results and discussions: 60 patients who complained of dizziness, on the basis of additional examination was diagnosed with BPPVs. Otitolithithiasis of the posterior semicircular canal was diagnosed in 44 patients, horizontal canal – in 8 patients, cupulo-lithiasis – in 10 patients. Depending on the condition of the vestibular systeme, patients were divided into 2 groups. Group 1 included 24 patients with peripheral vestibular disorders, group 2 included 36 patients with mixed vestibular dysfunction. According to the results of absorption densitometry in patients, mineral metabolism disorders were detected: osteopenia in 41 patients, the average T-test was (-1.9±0.3) SD, osteoporosis – In 19 patients, T-test was (-2.8 ± 0.2) SD. Serum calcium and vitamin D deficiency have been noted in patients with BPPV, indicating impaired mineral metabolism. In order to correct mineral metabolism and antirelapse therapy, patients with BPPV were prescribed vestibuloplegics, calcium, vitamin D for 12 months. Conclusions: studies have found a correlation between BPPV and bone mineral metabolic disorders. It indicated the presence of osteopenia and osteoporosis in patients with DPPD, as well as changes in the levels of mineral metabolism of bone (in addition to calcium and vitamin D in serrum). Such changes in mineral metabolism may be a biomarker of otolithic degeneration, maintain a causal relationship between lower serum vitamin D and calcium levels and the development of BPPV, and cause frequent attacks.