Abstract
Background
Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo and its recurrence is fairly common. Several studies correlated the pathophysiological role of different comorbidities—such as diabetes, osteoporosis, vascular, psychiatric and autoimmune diseases—in the development and recurrence of BPPV. The aim of this study is to analyse the pharmacological history of patients with idiopathic BPPV in relation to the risk of developing recurrence.
Methods
Data regarding 715 patients aged 12 to 87 years (62.7 ± 14) with non-traumatic BPPV were retrospectively evaluated. These refer to the Vestibular Service, day clinic, and were collected over a 4-year period, between 2014 and 2018.
Results
Recurrence of BPPV was observed in 220/715 patients (30.76%). A statistically significant correlation (p < 0.006) between recurrence and drug consumption was observed for SNC agents (p = 0.0001), vitamin D (p = 0.0005), PPI (p = 0.0007), thyroid hormones (p = 0.0011), and antihypertensives in single use (p = 0.0031). On the contrary, cholesterol-lowering statin drugs, hypoglycaemic agents, antiplatelet medication, estroprogestins and combination of two or more antihypertensives did not show significant correlation.
Conclusion
Specific classes of drugs are significantly associated with recurrence: antihypertensive therapy with a singular agent, central nervous system agents, PPIs, vitamin D and thyroid hormones. On the other hand, the lack of correlation between some drugs and recurrence could be linked to the effectiveness of therapy in controlling hypertension, dyslipidaemia and diabetes. Pharmacological history is an essential tool to identify patients at risk of BPPV recurrence.
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We have not received any funds from any kind of organization; the study is entirely the result of our work. We deny any kind of conflict of interest.
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This is not an experimental study, but a retrospective one, based on the analysis of data from medical records of patients referring to the Vestibular Service of our Institution.
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Picciotti, P.M., Di Cesare, T., Tricarico, L. et al. Is drug consumption correlated with benign paroxysmal positional vertigo (BPPV) recurrence?. Eur Arch Otorhinolaryngol 277, 1609–1616 (2020). https://doi.org/10.1007/s00405-020-05855-6
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DOI: https://doi.org/10.1007/s00405-020-05855-6