Vitamin D Deficiency and Benign Paroxysmal Positioning Vertigo: A Prospective One-year Study from Hospital Pedro Hispano

Introduction: Benign paroxysmal positioning vertigo (BPPV) is the most frequent cause of peripheral vertigo, being responsible for extremely intense complaints and for high health care costs. It has significant recurrence rates, mainly in older patients, leading to chronic dizziness and imbalance. Vitamin D deficiency is also very prevalent in general population.

Objective: To test the hypothetical relationship between recurrent BPPV and vitamin D deficiency.

Methods: Ten patients with diagnosis of BPPV made by history and physical exam and exclusion of neurologic and other otolaryngological diseases were selected. The whole sample had at least two episodes of documented BPPV in the previous two years and chronic complaints of dizziness. Vitamin D was evaluated by measure of serum 25-hydroxyvitamin D (25-OHD). Levels < 20 ng/mL were considered deficiency and levels between 20 and 30 ng/mL were considered insufficiency. Half of patients (treatment group) started a treatment with cholecalciferol. The remaining patients were the control group. All of the patients were reevaluated at office every three months.

Results: All of patients that ensued treatment with cholecalciferol did not have any episode of positional vertigo, nystagmus evoked by Dix-Hallpike and McClure-Pagnini maneuvers or dizziness complaints in the subsequent twelve months. Mean value of serum 25-OHD of treatment group in the third month (34,0 ng/mL) was significantly different from mean value of this group at beginning (13,8 ng/mL) and from mean value of control group (14,4 ng/mL). All of patients of control group had positional vertigo episodes and maintained dizziness complaints during follow-up, as well as positional nystagmus at office reevaluations.

Conclusion: These results are one more support to systematically measure and correct vitamin D levels in patients with recurrent BPPV, being a potential complement to the rehabilitation therapy.