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Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients
Roberto Teggi1, Riccardo Guidetti2, Omar Gatti1
1Division of Otolaryngology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Objectives:
Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear with a high rate of recurrence. Vascular disorders, migraine and autoimmune disorders have been considered facilitating factors for relapsing episodes. Our aim was to assess the role of vascular disorders, migraine and anti-thyroid antibodies in patients with recurrences.
Methods:
We retrospectively analysed records of 3042 patients treated for BPPV without other lifetime vertigo. Clinical data included previous vascular disorders of the central nervous system, heart disorders, migraine and recent head trauma. The presence of anti-thyroid autoantibodies was assessed in all patients.
Results:
Mean age of the first BPPV was 52.8 ± 14.5 years; there were 2339 females (76.9%), while 2048 (67.3%) of patients presented recurrences within two years of follow-up. Previous disorders of the central nervous system, presence of anti-thyroid antibodies, head trauma and migraine showed an association with recurrences. Above all, in subjects having the first BPPV while aged between 40 and 60 years, anti-thyroid antibodies were predictive for recurrences.
Conclusions:
Our data are consistent with the hypothesis that anti-thyroid autoantibodies may play a role in recurrences in subjects with initial manifestations between 40 and 60 years.
Insights
Anti-thyroid antibodies may predict recurrent benign paroxysmal positional vertigo (BPPV) in individuals aged 40-60. This finding suggests a link between autoimmune factors and BPPV recurrence, aiding in understanding and managing this inner ear disorder.
Area of Science:
- Neurology
- Immunology
- Otolaryngology
Background:
- Benign paroxysmal positional vertigo (BPPV) frequently recurs.
- Vascular disorders, migraine, and autoimmune conditions are suspected contributing factors to BPPV relapses.
Purpose of the Study:
- To investigate the association between vascular disorders, migraine, and anti-thyroid antibodies with BPPV recurrences.
- To identify predictive factors for BPPV relapse.
Main Methods:
- Retrospective analysis of 3042 BPPV patients without other vertigo history.
- Data collected included history of central nervous system vascular disorders, heart disease, migraine, head trauma, and anti-thyroid antibodies.
Main Results:
- Recurrences were observed in 67.3% of patients within two years.
- Central nervous system vascular disorders, anti-thyroid antibodies, head trauma, and migraine were associated with recurrences.
- Anti-thyroid antibodies were particularly predictive of recurrence in patients experiencing their first BPPV episode between ages 40 and 60.
Conclusions:
- Findings support the role of anti-thyroid autoantibodies in BPPV recurrences.
- This association is most notable in patients with initial BPPV onset between 40 and 60 years old.
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