Hyperparathyroidism and Dizziness: An Epidemiological Assessment

To determine the prevalence and odds ratios for benign paroxysmal positional vertigo and other dizziness conditions in hyperparathyroidism.

Analytical cross-sectional study from January 1, 2018, through December 31, 2023.

Single-institution tertiary care center.

Adults with primary or secondary hyperparathyroidism were analyzed through a population-based sample using ICD-10 diagnostic codes. The primary outcome included prevalence rates for benign paroxysmal positional vertigo and other dizziness conditions in primary and secondary hyperparathyroidism. Secondary outcomes consisted of odds ratios for benign paroxysmal positional vertigo and other dizziness conditions in primary versus secondary hyperparathyroidism, and with further systemic calcium dysregulation in the setting of vitamin D deficiency.

839 primary hyperparathyroidism and 1418 secondary hyperparathyroidism subjects were included. The prevalence of benign paroxysmal positional vertigo was 35.76 per 100 individuals in primary hyperparathyroidism, higher than in the general population (P = .01). Collectively, dizziness conditions were diagnosed as frequently in hyperparathyroidism as nephrolithiasis. The prevalence of benign paroxysmal positional vertigo did not statistically vary in secondary hyperparathyroidism from the general population, however, unspecified dizziness diagnoses were far more common than in primary hyperparathyroidism (P = .006). Benign paroxysmal positional vertigo and other dizziness conditions were more likely in subjects with vitamin D deficiency diagnosis.

Primary hyperparathyroidism is a risk factor for vertigo/benign paroxysmal positional vertigo. Hyperparathyroidism, both in primary and secondary disease, may be disruptive to otoconia. Further research is needed to understand this relationship. Improved understanding of risk factors for benign paroxysmal positional vertigo offers additional insight into the pathophysiologic mechanisms.