Division of Otolaryngology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vertigo Centre, Poliambulatorio Chirurgico Modenese, Italy.
Acta Otorhinolaryngol Ital. 2021 Oct;41(5):461-466. doi: 10.14639/0392-100X-N1233.
Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear with a high rate of recurrence. Vascular disorders, migraine and autoimmune disorders have been considered facilitating factors for relapsing episodes. Our aim was to assess the role of vascular disorders, migraine and anti-thyroid antibodies in patients with recurrences.
We retrospectively analysed records of 3042 patients treated for BPPV without other lifetime vertigo. Clinical data included previous vascular disorders of the central nervous system, heart disorders, migraine and recent head trauma. The presence of anti-thyroid autoantibodies was assessed in all patients.
Mean age of the first BPPV was 52.8 ± 14.5 years; there were 2339 females (76.9%), while 2048 (67.3%) of patients presented recurrences within two years of follow-up. Previous disorders of the central nervous system, presence of anti-thyroid antibodies, head trauma and migraine showed an association with recurrences. Above all, in subjects having the first BPPV while aged between 40 and 60 years, anti-thyroid antibodies were predictive for recurrences.
Our data are consistent with the hypothesis that anti-thyroid autoantibodies may play a role in recurrences in subjects with initial manifestations between 40 and 60 years.
良性阵发性位置性眩晕（BPPV）是一种内耳疾病，复发率很高。血管疾病、偏头痛和自身免疫性疾病被认为是复发的诱发因素。我们的目的是评估血管疾病、偏头痛和抗甲状腺抗体在复发患者中的作用。
我们回顾性分析了 3042 例无其他终身性眩晕的 BPPV 患者的记录。临床数据包括中枢神经系统、心脏疾病的既往血管疾病、偏头痛和近期头部外伤。所有患者均检测抗甲状腺自身抗体。
首次 BPPV 的平均年龄为 52.8±14.5 岁；女性 2339 例（76.9%），2048 例（67.3%）患者在随访 2 年内复发。既往中枢神经系统疾病、抗甲状腺抗体阳性、头部外伤和偏头痛与复发有关。尤其是在首次 BPPV 发生在 40 至 60 岁之间的患者中，抗甲状腺抗体是复发的预测因素。
我们的数据与以下假设一致，即抗甲状腺自身抗体可能在 40 至 60 岁之间首发表现的患者中复发中起作用。
