Osteopenia and osteoporosis in idiopathic benign positional vertigo

Jeong, Seong-Hae; Choi, Seo-Youn; Kim, J. Y.; Koo, Ja-Won; Kim, H. J.; Kim, J. S.

doi:10.1212/01.wnl.0000345016.33983.e0

Cited by 110 publications

(126 citation statements)

References 27 publications

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“…These studies used bone mineral density (BMD), a measurement of calcium levels in particular bone areas, as an indirect clinical indicator of osteoporosis and demonstrated a clear correlation between BPPV and BMD score. Some of these studies suggested that the occurrence of BPPV might be associated with osteoporosis or osteopenia [11,13,21,33], BPPV recurrence might be clinically predicted by a decreased BMD score [11,32], and medications used to treat osteoporosis or osteopenia might be helpful for preventing the occurrence and recurrence of BPPV [18].…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

Yang

Kim

Lee

et al. 2018

VES

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Abstract. The aim of this study was to evaluate the relationship between bone mineral density (BMD) and 25-hydroxyvitamin D with the occurrence and recurrence of BPPV. The records of 130 idiopathic BPPV patients (55 ± 12 years old, 30 men and 100 women) and 130 age-and sex-matched controls who underwent bone mineral densitometry between April 2012 and September 2015 were reviewed retrospectively. We compared the BMD and serum 25-hydroxyvitamin D between the patients and controls, and also compared the BMD between recurrent and non-recurrent BPPV groups. Among the female subjects, the BPPV group showed a significantly decreased BMD compared to the controls (p < 0.05). The men in the control group had significantly higher 25-hydroxyvitamin D levels than the men with BPPV (p < 0.05). Sixty-three patients (48%) reported recurrent attacks of BPPV. The women with recurrent BPPV were significantly older and showed a significantly lower BMD than non-recurrent women (p < 0.001). However, multiple regression analysis revealed that age alone was significantly associated with the recurrence of BPPV in women. BMD in women and serum 25-hydroxyvitamin D levels in men are associated with the occurrence of BPPV. Only age is an independent predictor of recurrence, though a low BMD and age correlate with the recurrence of BPPV.

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Section: Introductionmentioning

confidence: 99%

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

Yang

Kim

Lee

et al. 2018

VES

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Section: Discussionmentioning

confidence: 99%

“…The otoconia are in a dynamic state, and calcium and potassium are required to mineralize otoconia and to maintain any turnover in the otolith [26 ,27] . Two mechanisms have been proposed to explain the relationship between BPPV and abnormal calcium metabolism: 1) a disturbed internal structure of the otoconia or their interconnections and attachment to the gelatinous matrix and 2) a reduced capacity to dissolve the dislodged otoconia owing to increased concentration of free calcium in the endolymph, resulting from increased calcium resorption [28,29] .To this extent, both the cochlea and labyrinth were found to express crucial genes needed to constitute a Ca 2+ absorption mechanism to maintain low levels of endolymphatic Ca 2+ in order to sustain normal hearing and balance functions [30] . The Ca 2+ absorptive system comprises an apical membrane entry pathway (TRPV5 and TRPV6 channels), a cytosolic Ca 2+ buffer protein (calbindin-D9K and calbindin-D28K), and basolateral Ca 2+ exit pathways (sodium-calcium exchangers -NCX-) and plasma membrane Ca 2+ -ATPases (PMCA) [31] .…”

mentioning

confidence: 99%

A Pilot Study Using Intratympanic Methylprednisolone for Treatment of Persistent Posterior Canal Benign Paroxysmal Positional Vertigo

Pérez¹,

Franco²,

Oliva³

et al. 2016

Int Adv Otol

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OBJECTIVE:To assess the effect of intratympanic methylprednisolone (ITMP) in posterior canal benign paroxysmal positional vertigo (BPPV) that fails treatment involving repositioning maneuver in a case series. MATERIALS and METHODS:Nine patients with persistent posterior canal BPPV after 6 or more repositioning maneuvers were treated by ITMP (two weekly doses of 0.3-0.4 mL at 40 mg/mL) before repeating the repositioning procedures. RESULTS:Following ITMP treatment, 7 out of 9 patients were relieved of their symptoms and did not exhibit positional nystagmus after 1 or 2 repositioning maneuvers. The number of positional maneuvers performed before and after ITMP treatment in these 7 patients showed a statistically significant (p=0.016) reduction in the amount of repositioning treatments required. None of the 7 respondent patients showed any relapses during the follow-up period (follow-up range: 11-95 months). CONCLUSION:Administering ITMP before resuming repositioning procedures can be a useful treatment for persistent BPPV of the posterior canal. Intratympanic (IT) steroids are often used to treat inner ear disorders such as sudden idiopathic sensorineural hearing loss, autoimmune hearing loss, and Ménière's disease [14] . Corticosteroids exert their effects in the inner ear after interacting with intracellular glucocorticoid receptors by producing metabolic and anti-inflammatory effects. It is also known that glucocorticoid receptors are widespread throughout the inner ear, including semicircular canal duct epithelial cells, where they facilitate cation absorption via sodium channels [15][16][17] . KEYWORDS:Thus, considering the possibility of an inflammatory process of the labyrinth or an imbalance of Na + and Ca 2+ in the endolymph could be related with the intractability of BPPV, we have carried out a pilot study to assess the effect of IT methylprednisolone (ITMP) in persistent posterior canal BPPV. MATERIALS and METHODSThis prospective study included patients from 3 different hospitals. From January 2006 to March 2014, we diagnosed 187 patients affected from unilateral posterior canal BPPV. None of them had any symptoms or signs of central nervous system (CNS) disease. A complete otoneurological examination, including otoscopy, audiometry, head thrust test, spontaneous nystagmus recording, gaze-evoked nystagmus test, cover test, and Romberg and Fukuda tests, were performed in all the cases.The diagnosis of posterior canal BPPV was made by Dix-Hallpike test, showing a mixed vertical and torsional nystagmus beating toward the undermost ear, with appropriate latency and duration, and the direction of the nystagmus reversed on resuming the upright position. In every patient, the roll test and head hyperextension test were also performed in order to rule out lateral or superior canal BPPV.Patients with BPPV were treated by Epley or Semont maneuvers. We carried out only one of those maneuvers in every session. Each session, weekly programmed, began with a Dix-Hallpike test; if it was positive for the same posterior...

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“…Considering the high prevalence of vitamin deficiency and the growing body of evidences that links it to diseases, it may be sufficient to form a basis for population wide intervention. Since vitamin D is mainly and easily acquired through the skin under exposure to UVb sunlight, such recommendation may yet be another reason for an active and health lifestyle [20][21][22][23][24][25][26][27][28][29].…”

Section: Critical Summationmentioning

confidence: 99%

Vitamin D Deficiency to Ill Health Essay

Dubey¹

2017

JOENTR

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Osteopenia and osteoporosis in idiopathic benign positional vertigo

Abstract: Osteopenia/osteoporosis may be associated with idiopathic benign positional vertigo (BPV). The effectiveness of measuring bone mineral densitometry and restoring normal calcium metabolism for preventing recurrences of BPV requires further validation.

Cited by 110 publications

References 27 publications

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

A Pilot Study Using Intratympanic Methylprednisolone for Treatment of Persistent Posterior Canal Benign Paroxysmal Positional Vertigo

Vitamin D Deficiency to Ill Health Essay

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