Recurrence of benign paroxysmal positional vertigo.

OBJECTIVE

To determine the recurrence rate of benign positional paroxysmal vertigo (BPPV) and the factors associated to such recurrences.

STUDY DESIGN

Prospective study.

METHOD

Sixty-nine consecutive patients treated for first episode of BPPV.

STUDY PERIOD

63 months. Mean follow-up: 47 months.

RESULTS

The recurrence rate was 27%. Fifty percent of recurrences occurred in the first 6 months. Nineteen patients had 1 or more recurrence of BPPV; 10 had 1 recurrence, 7 patients had 2, and 2 patients had 3 recurrences. There was no significant difference in the recurrence rate according to sex, age, side, cause of BPPV, or instability after successful treatment. Multi-canal BPPV (log-rank, p = 0.024) and anterior canal BPPV (log-rank, p = 0.029) showed a significantly greater tendency to recur and to do so earlier. There was a significant difference in time to recurrence related to the number of maneuvers used to resolve the initial BPPV episode (log-rank, p = 0.023). Except for cases of BPPV secondary to labyrinthitis or neurolabyrinthitis, at least 70% of the recurrences affected a different side and/or different canal than the primary BPPV.

CONCLUSION

The recurrence rate of BPPV is 27%, and relapse largely occurs in the first 6 months. When BPPV recurrence is suspected, every canal on both sides must be investigated because it is the BPPV syndrome that recurs, rather than BPPV affecting a particular side or canal. Complex cases of BPPV have a greater risk of recurrence.