Benign paroxysmal positional vertigo natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

If left untreated, almost 100% of patients with BPPV may experience spontaneous recovery. Common complications of BPPV include nausea, vomiting, fainting, canal conversion, and cervical spine and neurological complications following Dix Hallpike or Epley maneuvers. Prognosis is generally excellent, and almost always BPPV will resolve over days to weeks on its own even without maneuvers or medications.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of BPPV usually develop after 40-50 years of life start with vertigo that last less than one minute and starts after specific head movements.[1]
  • If left untreated, almost 100% of patients with BPPV may experience spontaneous recovery.[2]

Complications

Prognosis

  • Prognosis is generally excellent, and almost always BPPV will resolve over days to weeks on its own even without maneuvers or medications.[2]
  • Resolving of the BPPV which is the result of head trauma or structural abnormalities might take a little more time.
  • Recurrence is common and happens in more than 30% of patients.
  • Patients older than 40 years of age, with horizontal BPPV or post traumatic BPPV are more susceptible to recurrence.

References

  1. Baloh RW, Honrubia V, Jacobson K (March 1987). "Benign positional vertigo: clinical and oculographic features in 240 cases". Neurology. 37 (3): 371–8. PMID 3822129.
  2. 2.0 2.1 del Rio, Maria; Arriaga, Moisés A. (2016). "Benign Positional Vertigo: Prognostic Factors". Otolaryngology-Head and Neck Surgery. 130 (4): 426–429. doi:10.1016/j.otohns.2003.12.015. ISSN 0194-5998.
  3. Bergin M, Bird P, Wright A (May 2010). "Internal carotid artery dissection following canalith repositioning procedure". J Laryngol Otol. 124 (5): 575–6. doi:10.1017/S0022215109991356. PMID 19785929.
  4. Hughes, C. Anthony; Proctor, Leonard (1997). "Benign Paroxysmal Positional Vertigo". The Laryngoscope. 107 (5): 607–613. doi:10.1097/00005537-199705000-00010. ISSN 0023-852X.

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