Effect of Vitamin D Deficiency on Incidence and Relapse of Benign Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is a peripheral labyrinth disease and is a prevalent cause of dizziness with a lifetime frequency of roughly 10%. Otoconia found in the otolith organ contain calcium carbonate and protein. Derangement in calcium homeostasis due to vitamin D is implicated in both the onset and recurrence of BPPV, and supplementation could play a role in preventing or alleviating the condition.

This prospective study enrolled a total of 60 patients with posterior semicircular canal BPPV. Subjects were divided into Group A with vitamin D<20ng/ml (45) and Group B with vitamin D>20ng/ml (15). Group A on day 1 received Canal Repositioning Manoeuvre (CRM) and vitamin D supplementation. Group B on day 1 received CRM only. Patients were followed up at 1,2,3, and 6 months and reassessed for vitamin D levels and relapse of BPPV.

Out of 60 subjects, 14 showed relapse, 23.3%. Out of 45 subjects in Group A, 13 showed relapse (28.9%). Among 15 patients in Group B, only 1 patient showed relapse (6.7%). Vitamin D levels in the supplementation group normalized before 3 months of follow-up. After 3 months, no relapse was noted in either of the groups. Hence, vitamin D-deficient BPPV patients showed a significantly a higher rate of relapse (p value 0.039).

This study demonstrates a high incidence of vitamin D deficiency among patients with BPPV. Also, patients with low vitamin D levels have higher rate of relapse of BPPV, and correction of vitamin D levels leads to a decrease in relapse frequency.