Demographic and clinical characteristics of BPPV patients: a retrospective large cohort study of 1599 patients

Abstract

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common peripheral vestibular problems, characterized by intense positionally provoked vertigo with a brief duration. However, studies of BPPV with demographic analyses are scant. To our knowledge, this is the largest retrospective analysis of BPPV patients seen in a 5-year period (2015-2019). The aim of this study is to document the demographic data of BPPV patients and describe the distribution of age, gender, the most common form and affected ears, associated comorbidities, type of treatment used, treatment efficacy, recurrence rates, prevalence of falls and postural instability. Predisposition for right posterior canal BPPV is almost unequivocally consistent in the literature. Hypertension is significantly associated with the occurrence of BPPV. The lower incidence of horizontal canal in this study may be explained by higher rates of spontaneous resolution and the exclusion of iatrogenic horizontal BPPV due to migration, while the lack of anterior canal BPPV was due to exclusion of atypical variants. There is also a high prevalence of falls and postural instability in BPPV patients, which requires further study. The demographic analyses are consistent with the literature, however treatment efficacy based on type of maneuver used, the influence of BPPV and its treatment on postural stability have not been sufficiently addressed. In this study, there is a high prevalence of self-reported falls (47.7%) and more than half of the patients (54%) with abnormal postural stability. Future prospective studies are necessary to validate such findings.