Patient, disease, and outcome characteristics of benign paroxysmal positional vertigo with and without Meniere's disease.

BACKGROUND

Meniere's disease (MD)-associated benign paroxysmal positional vertigo (BPPV) is complex and difficult to diagnose, and reports of its prevalence, pathologic features and outcomes are sparse and conflicting.

OBJECTIVE

Report disease characteristics and outcomes associated with the presence of MD in patients with BPPV.

MATERIALS/

METHODS

A retrospective study of patients with BPPV between 2007 and 2017 at a single, high-volume institution.

RESULTS

Of 1581 patients with BPPV identified, 7.1% had MD and 71.9% of those patients had BPPV in the same ear(s) as MD. Patients with MD were more likely to have lateral semicircular canalithiasis (11.6% vs. 5.5%, p = .009) and multiple canalithiasis (7.1% vs. 2.5%, p = .005). MD was associated with an increased rate of resolution of BPPV (p = .008) but also increased time to resolution (p = .007). There was no association between MD and recurrence of BPPV.

CONCLUSIONS

MD is associated with lateral canalithiasis. Contrary to prior reports, BPPV in MD can affect either ear and was not associated with poorer outcomes than idiopathic BPPV.

SIGNIFICANCE: The largest series to date investigating disease and outcome characteristics for BPPV in MD is presented. These data inform diagnosis and expectations in the management of these complex patients.