Recurrence of BPPV after successful treatment
Timothy C. Hain, MD •Page last modified:
March 7, 2021
Return to the main BPPV page.
Recurrent BPPV is very common. The table below lists recurrence rates in a large number of studies. Most of these studies are vague about the time frame, but we have omitted studies that explicitly said more than 2 years.
Recurrence of BPPV within 1-2 years
||Type of BPPV
||Benyon et al, 2000
||Helminski et al ,2005
||Tanimoto et al, 2008
||Dorigueto et al, 2009
||Perez et al, 2012
||Soto-Varela et al (2012)
||Babac et al, 2014
||Picicioti et al, 2016 (comment: duration of followup not given)
The average percentage BPPV recurrence, combining all studies listed above, was 22.35%. Not trivial.
The general thought is that BPPV, as well as it's recurrence, is mainly a function of "wear and tear", or in other words, age. According to AlGarni et al (2018), "when the recurrent BPPV groups were compared with the non-recurrent BPPV groups, the statistical analysis showed significantly lower level of vitamin D among the recurrence BPPV groups (SMD = - 4.47; 95% CI - 7.55 to - 1.29)." This does not appear to be a major effect, but rather appears to be a small risk factor. In other words, getting old is a far bigger risk factor than low vit-D.
- AlGarni MA, Mirza AA, Althobaiti AA, Al-Nemari HH, Bakhsh LS.Association of benign paroxysmal positional vertigo with vitamin D deficiency: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2018 Nov;275(11):2705-2711. doi: 10.1007/s00405-018-5146-6. Epub 2018 Oct 9.
- Beynon, G. J., et al. (2000). "Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre." J Otolaryngol 29(1): 2-6.
- Helminski, J. O., et al. (2005). "Strategies to prevent recurrence of benign paroxysmal positional vertigo." Arch Otolaryngol Head Neck Surg 131(4): 344-348.
- Tanimoto, H., et al. (2008). "Risk factors for recurrence of benign paroxysmal positional vertigo." J Otolaryngol Head Neck Surg 37(6): 832-835.
- Dorigueto, R. S., et al. (2009). "Benign paroxysmal positional vertigo recurrence and persistence." Braz J Otorhinolaryngol 75(4): 565-572.
- Perez, P., et al. (2012). "Recurrence of benign paroxysmal positional vertigo." Otol Neurotol 33(3): 437-443.
- Soto-Varela, A., et al. (2012). "Benign paroxysmal positional vertigo of the posterior semicircular canal: efficacy of Santiago treatment protocol, long-term follow up and analysis of recurrence." J Laryngol Otol 126(4): 363-371.
- Babac, S., et al. (2014). "Why do treatment failure and recurrences of benign paroxysmal positional vertigo occur?" Otol Neurotol 35(6): 1105-1110.
- Picciotti, P. M., et al. (2016). "Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience." Int J Audiol 55(5): 279-284.