Objectives: The objective of the present study was to examine the effects of serum 25‐hydroxyvitamin D concentrations on patients diagnosed with benign paroxysmal positional vertigo (BPPV) on BPPV recurrence.Study Design: Case series.Methods: A retrospective review of 232 patients diagnosed with BPPV visiting the clinic between June 2014 and June 2015 was performed. All patients underwent a complete otolaryngological, audiologic, and neurologic evaluation. The appropriate particle‐repositioning maneuver was performed depending on the type of BPPV. The patients were divided into the recurrence group and the nonrecurrence group. Age, gender, follow‐up period, type of BPPV, and vitamin D concentrations in the two groups were compared and analyzed through binary logistic regression analyses.Results: The average follow‐up period after treatment was 10.2 months. Forty‐one (17.7%) of 232 patients suffered a recurrence during the follow‐up period. The mean vitamin D concentration of 191 patients who did not suffer any recurrence was 16.63 ng/mL, whereas that of 41 patients who suffered a recurrence was 13.64 ng/mL. This difference in vitamin D concentrations was statistically significant (P < 0.019). The patients' age, gender, follow‐up period, and type of BPPV had no statistically significant impact.Conclusion: Vitamin D is assumed to affect BPPV as a recurrence factor independent of age, gender, follow‐up period, and type of BPPV.Level of Evidence: 4.

The purpose of the present study was to examine the effect of serum vitamin D concentrations on the longterm recurrence rates of benign paroxysmal positional vertigo (BPPV) patients. The present study was conducted with patients diagnosed with BPPV from June 2014 to April 2016. Whether the patients' sex, age, types and locations of semicircular canals, diabetes, hypertension, hyperlipidemia, and vitamin D concentrations affect their recurrence rates was examined using Pearson chi-square tests, independent samples t-tests and Cox proportional hazards regression analyses. The effects of vitamin D concentrations on long-term recurrence rates were examined using Kaplan-Meier estimates and log-rank tests. The recurrence rates obtained with Kaplan-Meier estimates were 18% and 50% at 12 months and 24 months, respectively. When the patients were divided into groups with vitamin D concentrations of <10 ng/mL and ≥10 ng/mL and the recurrence rates of the groups were compared, the difference was statistically significant (P=0.040). In addition, when the patients were divided into groups with vitamin D concentrations of <15 ng/mL and ≥15 ng/mL and the recurrence rates of the groups were compared, the difference was statistically quite significant (P=0.017). In a Cox regression model, variables such as age, sex, the types and locations of semicircular canals, hypertension, diabetes, hyperlipidemia, and 25-hydroxy vitamin D did not significantly affect recurrence. The present study investigated the recurrence rates of BPPV in patients for a long time without limiting the sex, age, or locations of semicircular canals and it could be seen that serum vitamin D concentrations significantly affected the recurrence of BPPV.

Positional vertigo manifests as a spinning sensation triggered by changes in head position relative to gravity. Benign paroxysmal positional vertigo (BPPV) is an inner ear disorder characterized by recurrent episodes of positional vertigo. The connection between vitamin D insufficiency/deficiency and the onset and recurrence of BPPV is established. This study aims to assess vitamin D as a recurring factor in BPPV and the efficacy of vitamin D supplementation in preventing its recurrence. A comprehensive literature review on the relationship between vitamin D and BPPV recurrence was conducted, searching PubMed, Embase, Web of Science, and article reference lists for studies published from 2020 to 2023. A total of 79 articles were initially identified through the search, with 12 of them being utilized in the study. Recurrence rates for BPPV varied from 13.7% to 23% for studies with follow-up less than 1 year and 13.3% to 65% for studies with follow-up equal to or exceeding 2 years. Risk factors for BPPV recurrence include advanced age, female sex, hypertension, diabetes mellitus, hyperlipidemia, osteoporosis, and vitamin D deficiency. While earlier studies did not establish a link between low vitamin D levels and initial BPPV occurrence, they did associate recurrent episodes with low vitamin D levels. Recent research indicates that vitamin D supplementation in BPPV patients with deficiency or insufficiency decreases both the numbers of relapsing patients and relapses per patient. To validate these findings across diverse populations, further randomized controlled studies with larger cohorts and extended follow-up durations are essential.

Blood pressure is maintained by a combined mechanism of the baroreceptor reflex and the vestibulosympathetic reflex. This study is intended to verify the hypothesis that the orthostatic hypotension (OH) seen when benign paroxysmal positional vertigo (BPPV) occurred may act as a factor that affects the recurrence of BPPV. The subjects of present study were selected from among 239 patients diagnosed with idiopathic BPPV. The average age of the group with OH was 59.3 years, and the age of the group without OH was 50.3 years, with a statistically significant difference (P = 0.013). It was shown that drug-taking increased the risk of OH occurrence by 4.08 times (C.I for exp(B): 1.20–13.77) compared to the group that did not take drugs. It was shown that the risk of recurrence of BPPV was significantly reduced in the no recurrence group compared to the multiple recurrence group when there was no OH (p = 0.000; aOR 0.0000002). Also, the risk of recurrence was significantly reduced in the no recurrence group compared to the multiple recurrence group when there was no drug-taking (p = 0.000 aOR 0.0000001). This study is the first study that studied the effect of OH on the recurrence of BPPV and showed the possibility that OH could partially influence the recurrence of BPPV.

Introduction There have been reports indicating that patients with frequently recurring benign paroxysmal positional vertigo (BPPV) had vitamin D deficiency, and some studies indicated that the treatment of severe vitamin D deficiency is effective in the reduction of the recurrence of BPPV. Objective The purpose of the present study was to examine the effects of Vitamin D₃ injection on recurrence among patients with a 10 ng/mL or lower 25-hydroxyvitamin D blood concentration diagnosed with BPPV. Methods Among 99 patients with idiopathic BPPV with vitamin D deficiency, 25 patients (case group) were submitted to 3 to 4 injections of 200,000 IU of vitamin D₃ in the first year. In total, 50 patients in the control group were selected through frequency matching, with 25 patients in the case group. Age, gender, and type of BPPV are used in matching variables with 1:2 matched data. The subjects of the study group were followed up for 24 months. Results The differences in relapse rates between the case and the control groups were examined using the non-parametric Kruskal-Wallis test for k independent samples. With regard to the relapse rates of the entire case and control groups by period, from 0 to 6 months (p < 0.531), from 7 to 12 months (p < 1.000), and from 13 to 24 months (p < 0.711), and in the entire study period (p < 0.883) there were no statistically significant differences. Conclusion The present case-control study indicated that vitamin D₃ injection had no significant effect on the recurrence of BPPV patients with vitamin D deficiency when age, gender, and type of BPPV were homogeneous between the two groups.

Background: Otolith organ acts complementarily with the autonomic nervous system to maintain blood pressure. However, the effect of blood pressure variability in the autonomic nervous system on otolith organ has not yet been determined. This study aimed to verify the hypothesis that blood pressure variability in the autonomic nervous system affects the recurrence of benign paroxysmal positional vertigo (BPPV), which is the most common disease of the vestibular organs, by using the head-up tilt test (HUTT). Methods: This study included 432 patients diagnosed with idiopathic BPPV. The follow-up period for all patients was 12 months. Age, sex, hypertension, diabetes and recurrence were analyzed. The HUTT parameters were divided into a group of patients whose average diastolic blood pressure increased in the upright position compared to supine position during the HUTT (DBP₁) and a group of patients whose average diastolic blood pressure decreased in the upright position compared to supine position during the HUTT (DBP₂). Model selection, general loglinear analysis, and logit loglinear analysis were performed using a hierarchically progressing loglinear analysis. Results: In summary, the group with increased average diastolic blood pressure (DBP₁) showed a higher tendency for BPPV recurrence compared to the group with decreased diastolic blood pressure (DBP₂) in the upright position during the HUTT, although the difference was not statistically significant (p = 0.080). However, in males, the DBP₁ group demonstrated a significantly higher recurrence rate of BPPV than the DBP₂ group during the HUTT (95% CI, -20.021 to -16.200; p < 0.001). Conclusions: It is presumed that poor autonomic nervous system response through vestibulosympathetic reflex maintains elevated diastolic blood pressure in the upright position during the HUTT. This variability is assumed to affect the recurrence of BPPV.