Patient, disease, and outcome characteristics of benign paroxysmal positional vertigo with and without Meniere’s disease

Abstract

Background: Meniere’s disease (MD)-associated benign paroxysmal positional vertigo (BPPV) is complex and difficult to diagnose, and reports of its prevalence, pathologic features and outcomes are sparse and conflicting.

Objective: Report disease characteristics and outcomes associated with the presence of MD in patients with BPPV.

Materials/methods: A retrospective study of patients with BPPV between 2007 and 2017 at a single, high-volume institution.

Results: Of 1581 patients with BPPV identified, 7.1% had MD and 71.9% of those patients had BPPV in the same ear(s) as MD. Patients with MD were more likely to have lateral semicircular canalithiasis (11.6% vs. 5.5%, p = .009) and multiple canalithiasis (7.1% vs. 2.5%, p = .005). MD was associated with an increased rate of resolution of BPPV (p = .008) but also increased time to resolution (p = .007). There was no association between MD and recurrence of BPPV.

Conclusions: MD is associated with lateral canalithiasis. Contrary to prior reports, BPPV in MD can affect either ear and was not associated with poorer outcomes than idiopathic BPPV.

Significance: The largest series to date investigating disease and outcome characteristics for BPPV in MD is presented. These data inform diagnosis and expectations in the management of these complex patients.

Chinese abstract

背景：美尼尔氏病（MD）伴发的良性阵发性位置性眩晕（BPPV）很复杂且难以诊断, 关于其发病率、病理特征和结果的报道很少且相互矛盾。

目的：报告BPPV患者的与MD存在相关的疾病特征和结果。

材料/方法：在单个大医院中对2007至2017年BPPV患者进行回顾性研究。

结果：在1581名BPPV患者中, 有7.1％患有MD, 其中的71.9％在与MD相同一侧的耳中患有BPPV。 MD患者更可能患侧半规管结石（11.6％比5.5％, p = .009）和多发性结石（7.1％比2.5％, p = .005）。 MD与BPPV治愈率增加相关（p = .008）, 但也增加了治愈时间（p = .007）。 MD与BPPV的复发之间没有关联。

结论：MD与侧半规管结石有关。与之前的报道相反, MD患者的BPPV可能会影响任何一只耳, 并且与特发性BPPV相比并不会导致更差的结果。

意义：介绍了迄今为止针对MD的BPPV疾病特征和结果特征的最大系列研究。这些资料为这些复杂患者的治疗提供了诊断和希望。

Keywords:

• Benign paroxysmal positional vertigo
• Meniere’s disease
• vertigo
• neurotology

Disclosure statement

No potential conflict of interest was reported by the authors.