Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review

Yu, Shudong; Liu, Fenye; Cheng, Zihao; Wang, Qirong

doi:10.1186/1471-2377-14-110

Cited by 83 publications

(63 citation statements)

References 19 publications

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“…Possible associations between osteoporosis (osteopenia) and BPPV have also been reported. 129 Patients with both conditions may be at greater risk for fractures resulting from falls related to BPPV; therefore, patients with combined osteoporosis and subsequent BPPV should be identified and monitored closely for fall and fracture risk. Examined from a different vantage point, patients with a history of recurrent falls, particularly among the elderly, should be assessed for underlying BPPV as 1 of the potential fall-precipitating diagnoses.…”

Section: Action Statement Profile For Statement 2bmentioning

confidence: 99%

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

568

776

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Objective. This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV.Purpose. The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV.Action Statements. The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate...

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Section: Action Statement Profile For Statement 2bmentioning

confidence: 99%

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

568

776

View full text Add to dashboard Cite

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“…In 2003, Vibert et al [4] observed that osteoporosis, osteopenia, and disorders of calcium metabolism presented more often in female BPPV patients Association of Benign Paroxysmal Positional Vertigo with Osteoporosis and Vitamin D Deficiency: A Case Controlled Study over 50 years of age and concluded that osteopenia and osteoporosis could be potential etiological factors in BPPV. In consequent years, studies conducted in several regions reported a prevalence of osteoporosis and vitamin D (vit D) deficiency in BPPV patients [3,[14][15][16][17] . However, these studies all had major selection bias in that the control group did not represent the population [3,6,14,15] .…”

Section: Introductionmentioning

confidence: 99%

Association of Benign Paroxysmal Positional Vertigo with Osteoporosis and Vitamin D Deficiency: A Case Controlled Study

Karataş¹,

Yüceant²,

Yüce³

et al. 2017

Int Adv Otol

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OBJECTIVE:Benign paroxysmal positional vertigo (BPPV) is a common type of vertigo caused by the peripheral vestibular system. The majority of cases are accepted as idiopathic. Calcium metabolism also plays a primary role in the synthesis/absorption of otoconia made of calcium carbonate and thus might be an etiological factor in the onset of BPPV. In this study, we aimed to investigate the role of osteoporosis and vitamin D in the etiology of BPPV by comparing BPPV patients with hospital-based controls. MATERIALS and METHODS:This is a case-control study comparing the prevalence of osteoporosis and vitamin D deficiency in 78 BPPV patients and 78 hospital-based controls. The mean T-scores and serum vitamin D levels were compared. The risk factors of osteoporosis, physical activity, diabetes mellitus, body mass index, and blood pressure were all compared between the groups. To avoid selection bias, the groups were stratified as subgroups according to age, sex, and menopausal status. RESULTS:In this study, the rates of osteoporosis and vitamin D deficiency detected in BPPV patients were reasonably high. But there was no significant difference in mean T-scores and vitamin D levels, osteoporosis, and vitamin D deficiency prevalence between the BPPV group and controls. CONCLUSION:The prevalence of osteoporosis and vitamin D deficiency is reasonably high in the general population. Unlike the general tendencies in the literature, our study suggests that osteoporosis and vitamin D deficiency are not risk factors for BPPV; we conclude that the coexistence of BPPV with osteoporosis and vitamin D deficiency is coincidental.

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“…17 Osteoporosis and osteopenia may be factors increasing the likelihood of erosion and degeneration of otoconia. 18 Such a process could potentially explain the greater prevalence of idiopathic BPPV in women because of estrogen effects on calcium deposition. The number of otoconia and size was diminished in osteoporotic rats.…”

Section: Epidemiologymentioning

confidence: 99%