POSITIONAL VERTIGO


Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders with an estimated lifetime prevalence of 2.4% in the general adult population. Of the 5.6 million clinic visits per year in the United States for dizziness, it is estimated that between 17% and 42% of patients with vertigo are diagnosed with BPPV. Although this disorder affects people across their lifespan, it tends to affect individuals aged 50 to 70 years and therefore has some noteworthy societal burdens. For example, it is estimated that $2000 is spent on average to diagnose BPPV and that 86% of patients have interruption in their daily activities and lost work days because of the vertigo  symptoms.

Furthermore, older patients with BPPV have a greater incidence of falls and impairments to their daily activities. These falls can cause secondary injuries, including hip fractures, and can lead to additional costs from hospital and nursing home admissions.

Therefore, this disorder affects not only an individual’s quality of life but also the society.
The true incidence and prevalence of BPPV is difficult to accurately estimate. For example, a study in Japan estimated the incidence to be 0.01%, whereas one done in Minnesota estimated it to be 0.06% with an increase of 38% with each decade of life. However, it is likely that these early epidemiologic studies were underestimates because they included only those patients who presented to physicians with their acute vestibular problem and did not include those who never reported to physicians.
A recent study in Germany looked at the estimated prevalence and incidence of
BPPV in the general adult population. The investigators used a cross-sectional nationally representative survey of the general adult population in Germany and found a prevalence of 2.4% overall with a prevalence of 3.2% in females and 1.6% in males. The 1-year incidence was calculated at 0.6%, which is approximately 10 times higher than earlier estimates. In this study, the 1-year prevalence was also broken down by age.
In patients aged 18 to 39 years, the estimated prevalence was 0.5%. From 40 to 59 years of age, the prevalence was 1.7%. Finally, for patients older than 60 years, the estimated prevalence was 3.4%

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