Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency

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• 作者：Hossam Sanyelbhaa Talaat^a ; ^{Sanyelbhaa@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Abdel-Magied Hasan Kabel^a ; ¹ ; Lobna Hamed Khaliel^b ; ² ; Ghada Abuhadied^c ; ³ ; Heba Abd El-Rehem Abo El-Naga^d ; ⁴ ; Ahmed Sanyelbhaa Talaat^e ; ⁵
• 关键词：BPPV recurrence ; Vitamin D deficiency ; Vertigo ; Dizziness
• 刊名：Auris Nasus Larynx
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：43
• 期：3
• 页码：237-241
• 全文大小：607 K

文摘

Several studies correlated between vitamin D deficiency and the development, and the recurrence of benign positional paroxysmal vertigo (BPPV), but none of them proved that treatment of vitamin D deficiency would reduce the recurrence rate of BPPV. This study aims to detect the effect of treatment of severe vitamin D deficiency on the recurrence rate of BPPV.

Methods

The inclusion criteria of the study group were: (1) Unilateral, idiopathic, posterior canal BPPV with no history suggestive of secondary BPPV and (2) 25-hydroxyvitamin D3 level ≤10 ng/ml. All subjects enrolled in the current study underwent detailed clinical history, audiovestibular evaluation consisting of pure-tone audiometry, Immittancemetry, Videonystugmography, serum 25-hydroxyvitamin D3 assessment, and Dual-energy X-ray absorptiometry (DXA). Vitamin D therapy was prescribed for the study group. Serum 25-hydroxyvitamin D3 level was evaluated twice, on recruitment into the study group and 3 months after commencing vitamin D therapy. According to the results of the second evaluation of serum 25-hydroxyvitamin D3, the study group was subdivided into two subgroups: Subgroup (I): including 28 subjects who disclosed elevation of serum 25-hydroxyvitamin D3 level; improvement ≥10 ng/ml. Subgroup (II): including 65 patients who disclosed elevation of serum 25-hydroxyvitamin D3 levels <10 ng/ml. The study group was followed up for 18 months in order to observe the recurrence of BPPV.

Results

The differences between both study subgroups (I) & (II) regarding age, sex distribution, and bone mineral density were insignificant. The number of subjects who had recurrence of BPPV in subgroup (I) was 4 (14%) versus 28 subjects (43%) in subgroup (II). The mean values for recurrent attacks/subject in subgroups (I) & (II) were 0.18, and 0.66 attack/subject respectively; these differences between both subgroups were of high statistical significance (p < 0.01). The Odds Ratio for development of recurrence of BPPV in subjects with severe vitamin D deficiency was 4.54 (95% CI: 1.41–14.58, p < 0.01). The relapse attacks of BPPV affected both ears irrespective of the ear showing the original BPPV attack.

Conclusion

The present study indicates that improvement of serum 25-hydroxyvitamin D3 levels is associated with substantial decrease in recurrence of BPPV.