Risk factors for recurrence of benign paroxysmal positional vertigo.

OBJECTIVE: To assess the results of treatment for a first episode of benign paroxysmal positional vertigo (BPPV) and risk factors for recurrence.

STUDY DESIGN: Retrospective chart review of 148 BPPV patients at a tertiary care referral centre.

MATERIALS AND METHODS: The canalith repositioning procedure (CRP) was performed until vertigo and nystagmus were resolved. Using multivariate logistic regression, we estimated the relationship between the rate of BPPV recurrence within 1 year and various risk factors for BPPV.

RESULTS: Among the 145 patients after successful manoeuvre or spontaneous resolution, BPPV recurred in 31 patients (21%) within 1 year. Patients with recurrent BPPV in the posterior semicircular canal required more CRP sessions and a longer period. The rate of BPPV recurrence in patients with endolymphatic hydrops (75%) was significantly higher than in those without (odds ratio 17; 95% confidence interval 2.9-101). Both the first episode of BPPV and recurrent BPPV affected the same ear associated with endolymphatic hydrops in all patients with this complication.

CONCLUSIONS: Our data suggest that endolymphatic hydrops is a risk factor for recurrence of BPPV and that prevention of recurrent BPPV is important for control of endolymphatic hydrops.