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Osteopenia and osteoporosis in idiopathic benign positional vertigo

From the Departments of Neurology (S.-H.J., J.S.K.), Internal Medicine (S.H.C.), Family Medicine (J.-Y.K.), and Otolaryngology (J.-W.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital; Department of Neurology (S.-H.J.), Eulji University School of Medicine, Eulji University Hospital; and Pharmacoepidemiology Division (H.J.K.), Clinical Trial Center, Seoul National University Hospital, Korea.

Address correspondence and reprint requests to Dr. Ji Soo Kim, Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea jisookim{at}snu.ac.kr.

Objective: Causes of benign positional vertigo (BPV) are mostly unknown. The aim of this study was to elucidate an association of osteoporosis with idiopathic BPV.

Methods: Two hundred nine consecutive patients with a confirmed diagnosis of idiopathic BPV underwent bone mineral densitometry of anterior–posterior lumbar spine and femur. The T scores were compared with those of 202 controls without a history of dizziness. Recurrence was defined when the patients reported two or more previous episodes of positional vertigo similar to those experienced at the time of diagnosis.

Results: In both women and men, the lowest T scores were decreased in patients with BPV compared with those in controls. Furthermore, the prevalences of osteopenia (–2.5 < T score < –1.0) and osteoporosis (T score –2.5) were higher in both women and men with BPV than in controls. Multiple logistic regression analyses adjusted for age, sex, alcohol, smoking, and hyperphosphatemia showed that only the existence of osteopenia/osteoporosis was associated with an increased risk of BPV (adjusted odds ratio of osteopenia = 2.0, 95% confidence interval 1.2–3.4, p = 0.011; adjusted odds ratio of osteoporosis = 3.1, 95% confidence interval 1.4–7.2, p = 0.007). In women aged 45 years, the lowest T scores were also decreased in the recurrent group, compared with those in the de novo group.

Conclusion: Osteopenia/osteoporosis may be associated with idiopathic benign positional vertigo (BPV). The effectiveness of measuring bone mineral densitometry and restoring normal calcium metabolism for preventing recurrences of BPV requires further validation.

Abbreviations: BMD = bone mineral density; BPV = benign positional vertigo; BPV-AC = BPV involving the anterior canal; BPV-HC = BPV involving the horizontal canal; BPV-PC = BPV involving the posterior canal.

Supplemental data at www.neurology.org.

J.S.K. was supported by the second stage Brain Korea 21 project in 2006.

Disclosure: The authors report no disclosures.

Received September 2, 2008. Accepted in final form November 25, 2008.

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				Osteoporosis and Benign Positional Vertigo Journal Watch Neurology, June 30, 2009; 2009(630): 2 - 2. [Full Text]