Objectives: To examine the prevalence and incidence, the clinical presentation, societal impact and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general population.
Methods: Cross-sectional, nationally representative neurotologic survey of the general adult population in Germany with a two-stage sampling design: screening of 4,869 participants of the German National Telephone Health Interview Survey 2003 (response rate 52%) for moderate or severe dizziness or vertigo followed by validated neurotologic interviews (n=1003; response rate 87%). Diagnostic criteria for BPPV were at least five attacks of vestibular vertigo lasting less than one minute without concomitant neurologic symptoms and invariably provoked by typical changes of head position. In a concurrent validation study (n = 61) conducted in two specialised dizziness clinics, BPPV was detected by our telephone interview with a specifity of 92% and a sensitivity of 88% (positive predictive value 88%, negative predictive value 92%).
Results: Benign paroxysmal positional vertigo accounted for 8% of individuals with moderate or severe dizziness/vertigo. The lifetime prevalence of BPPV was 2.4%, the 1-year prevalence 1.6%, and the 1-year incidence was 0.6%. The median duration of an episode was two weeks. In 86% of affected individuals, BPPV led to medical consultation, interruption of daily activities or sick leave. Altogether, only eight percent of affected participants received effective treatment. On multivariate analysis, age, migraine, hypertension, hyperlipidemia and stroke were independently associated with BPPV.
Conclusion: Benign paroxysmal positional vertigo is a common vestibular disorder leading to significant morbidity, psychosocial impact and medical costs.
- benign paroxysmal positional vertigo
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