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Giant cell arteritis: a new association with benign paroxysmal positional vertigo
Juan C Amor-Dorado1, Javier Llorca, Carmen Costa-Ribas
1Department of Otorhinolaryngology, Hospital Xeral-Calde, Lugo, Spain.
The Laryngoscope
|July 29, 2004
Summary
Giant cell arteritis (GCA) patients show a significantly higher incidence of benign paroxysmal positional vertigo (BPPV) and positional nystagmus compared to controls. This suggests an ischemic etiology for BPPV in GCA, potentially indicating a new association.
Area of Science:
- Neurology
- Ophthalmology
- Rheumatology
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium arteries.
- Clinical manifestations of GCA are often attributed to ischemic complications.
- Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.
Purpose of the Study:
- To determine the incidence and characteristics of BPPV and positional nystagmus in patients with GCA.
- To compare these findings with a matched control group.
Main Methods:
- Prospective study of 44 GCA patients meeting 1990 ACR criteria.
- Otologic and oculographic evaluations performed within 1 week of corticosteroid therapy.
- Comparison with 44 age, sex, and ethnically matched controls, with follow-up at 3 and 6 months.
Main Results:
- BPPV incidence was 20.5% in GCA patients versus 2.3% in controls (P=.007).
- Posterior semicircular canals were most affected in GCA patients with BPPV.
- Horizontal nystagmus in the head hanging position test occurred in 7 GCA patients, none in controls (P=.006).
Conclusions:
- GCA patients exhibit a higher frequency of BPPV and positional nystagmus than matched controls.
- Ischemic complications of GCA are suggested as the cause of BPPV in this population.
- GCA may represent a new association with BPPV.