Vitamin D Insufficiency/Deficiency in Patients with Recurrent Benign Paroxysmal Positional Vertigo

BACKGROUND: The aim of this study is to verify if (1) there is a link between hypovitaminosis D and benign paroxysmal positional vertigo, (2) the number of benign paroxysmal positional vertigo relapses decreases after vitamin D supplementation; and (3) benign paroxysmal positional vertigo response to physical therapy improves after hypovitaminosis D correction. METHODS: We enrolled 26 patients with benign paroxysmal positional vertigo and 24 subjects, who never suffered from vertigo, as a control group. All benign paroxysmal positional vertigo patients underwent physical therapy, once a week, until benign paroxysmal positional vertigo resolution. All participants were subjected to a dosage of serum 25(OH) vitamin D. In patients with hypovitaminosis D, we prescribed cholecalciferol. After 3 months of therapy, all patients were asked to undergo a second dosage of serum 25(OH) vitamin D. For each patient, we counted the number of maneuvers required to resolve each episode of benign paroxysmal positional vertigo before and after vitamin D supplementation. RESULTS: At T0, both patients and controls had insufficient average vitamin D serum levels (23.18 and 23.73 ng/ml) without significant differences between groups (p 0.16). However, the percentage of patients who had a serum vitamin D deficiency before supplementation was higher than that of the control group (65.39% and 33.3%). The latter finding was statistically significant with a P = 0.002. Before integration 100% of patients had a recurrent BPPV (average number of recurrences/pt: 9.31) while after supplementation only 5/16 pts (31.25%) had just 1 recurrence ( average number of relapses/pt 0.31, P = 0.0003). The average number of maneuvers before and after supplementation was 1.37 and 1.0 respectively (P = 0.6543). CONCLUSION: Our results suggest that (1) there is a relationship between vitamin D deficiency and the onset of BPPV, (2) hypovitaminosis correction is able to reduce both the number of patients relapsing and the number of relapses per patient, and (3) we have not found a significant effect of vitamin D supplementation as regards the responsivity of benign paroxysmal positional vertigo to physical therapy.