Development Of Benign Paroxysmal Positional Vertigo Research Articles

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

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.

Benign Paroxysmal Positional Vertigo Risk Factors Unique to Perimenopausal Women.

Many investigations have found common occurrences of benign paroxysmal positional vertigo (BPPV) in women, and clinical experience has shown that BPPV can develop due to increased hormonal fluctuations, especially during menopause. Therefore, knowledge about neurochemicals and their involvement with BPPV is imperative for the management of neurological issues in women. This review will discuss appropriate gender-based considerations of BPPV based on experimental and clinical evidence. The studies describe 2 lines of evidence regarding the association of perimenopause in women and the development of BPPV: (1) experimental evidence: the existence of estrogen receptors in the inner ear, otoconial malformations in osteopenic/osteoporotic rats, changes in otoconin 90 caused by hormone replacement therapy, and impaired calcium absorption following estrogen deprivation corrected by estrogen replacement therapy and (2) clinical evidence: epidemiological aspects, osteoporosis and estrogen deficiency. Future studies are necessary to validate the effects of hormonal replacement therapy and phytoestrogen in women with recurrent BPPV.

Oxidative Status in Patients with Benign Paroxysmal Positional Vertigo.

Benign paroxysmal positional vertigo (BPPV) is the most frequent peripheral vestibular disorder and is particularly seen among older patients suffering from vertigo. The brief vertigo attacks in and imbalance symptoms of BPPV are caused by freely floating otoconia within the semicircular canals. The aim of this prospective study was to evaluate the role of oxidative stress, using native thiol/disulfide (SH/SS) homeostasis as a novel indicator, in the etiology of BPPV. The 62 participants in the study included 31 patients with BPPV and, as the control group, 31 healthy individuals without any cochleovestibular disorders. Patients with BPPV initially had significantly lower native SH levels and significantly lower SH/total thiol (TT) ratios, as well as significantly higher SS/SH and SS/TT ratios, than the healthy controls. After successful treatment of their vertigo, which was confirmed based on the results obtained from the second blood sample, patients with BPPV still had lower SH levels and SH/TT ratios and significantly higher SS/SH and SS/TT ratios than the healthy controls. Our results suggest a role of oxidative stress in the development of BPPV, through both calcium metabolism and the direct toxic effects of free oxygen radicals, including the triggering of apoptosis.