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Epidemiology of benign paroxysmal positional vertigo: a population based study
  1. M von Brevern1,
  2. A Radtke1,
  3. F Lezius1,
  4. M Feldmann1,
  5. T Ziese2,
  6. T Lempert3,
  7. H Neuhauser2
  1. 1Department of Neurology, Charité, Campus Virchow-Klinkum, Berlin, Germany
  2. 2Robert Koch Institute, Berlin, Germany
  3. 3Department. of Neurology, Schlosspark-Klinik, Berlin, Germany
  1. Correspondence to:
 Dr Michael von Brevern
 Neurologische Klinik, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany; michael.von_brevern{at}


Objectives: To examine the prevalence and incidence, clinical presentation, societal impact and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general population.

Methods: Cross-sectional, nationally representative neurotological survey of the general adult population in Germany with a two stage sampling design: screening of 4869 participants from the German National Telephone Health Interview Survey 2003 (response rate 52%) for moderate or severe dizziness or vertigo, followed by validated neurotological interviews (n = 1003; response rate 87%). Diagnostic criteria for BPPV were at least five attacks of vestibular vertigo lasting <1 min without concomitant neurological symptoms and invariably provoked by typical changes in head position. In a concurrent validation study (n = 61) conducted in two specialised dizziness clinics, BPPV was detected by our telephone interview with a specificity of 92% and a sensitivity of 88% (positive predictive value 88%, negative predictive value 92%).

Results: BPPV accounted for 8% of individuals with moderate or severe dizziness/vertigo. The lifetime prevalence of BPPV was 2.4%, the 1 year prevalence was 1.6% and the 1 year incidence was 0.6%. The median duration of an episode was 2 weeks. In 86% of affected individuals, BPPV led to medical consultation, interruption of daily activities or sick leave. In total, only 8% of affected participants received effective treatment. On multivariate analysis, age, migraine, hypertension, hyperlipidaemia and stroke were independently associated with BPPV.

Conclusion: BPPV is a common vestibular disorder leading to significant morbidity, psychosocial impact and medical costs.

  • BPPV, benign paroxysmal positional vertigo
  • GNT-HIS, German National Telephone Health Interview Survey
  • HIS, International Headache Society

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  • See Editorial Commentary, p 663

  • Published Online First 29 November 2006

  • Competing interests: None.

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