Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis

doi:10.1007/s00415-020-09952-8

Review

. 2022 Feb;269(2):619-626.

doi: 10.1007/s00415-020-09952-8. Epub 2020 Aug 7.

Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis

Seong-Hae Jeong¹, Sun-Uk Lee², Ji-Soo Kim^{3

4}

Affiliations

¹ Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
² Department of Neurology, Korea University Medical Center, Seoul, Republic of Korea.
³ Department of Neurology, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Seoul, 463-707, Korea. jisookim@snu.ac.kr.
⁴ Dizziness Center, Seoul National University Bundang Hospital, Seongnam, Korea. jisookim@snu.ac.kr.

PMID: 32767116
DOI: 10.1007/s00415-020-09952-8

Review

Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis

Seong-Hae Jeong et al. J Neurol. 2022 Feb.

. 2022 Feb;269(2):619-626.

doi: 10.1007/s00415-020-09952-8. Epub 2020 Aug 7.

Authors

Seong-Hae Jeong¹, Sun-Uk Lee², Ji-Soo Kim^{3

4}

Affiliations

¹ Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
² Department of Neurology, Korea University Medical Center, Seoul, Republic of Korea.
³ Department of Neurology, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Seoul, 463-707, Korea. jisookim@snu.ac.kr.
⁴ Dizziness Center, Seoul National University Bundang Hospital, Seongnam, Korea. jisookim@snu.ac.kr.

PMID: 32767116
DOI: 10.1007/s00415-020-09952-8

Abstract

Research background: Vitamin D insufficiency/deficiency is known to be related to occurrences and recurrences of benign paroxysmal positional vertigo (BPPV). However, the efficacy of vitamin D supplementation in reducing recurrences of BPPV remains to be established. We performed a meta-analysis to determine the therapeutic effects of vitamin D supplementation, with or without calcium, for preventing recurrences of BPPV.

Methods: We searched the PubMed, the Embase, the Web of Science and the reference lists of the articles. We included randomized or non-randomized trials that determined the efficacy of supplementing vitamin D or related compounds, alone or with calcium, in comparison to placebo or no intervention in preventing recurrences of BPPV. The primary outcome was the number of patients with BPPV recurrences. Data were collected and pooled using a weighted relative risk (RR) with corresponding 95% CIs, where possible, by adopting the fixed-effect or random-effect model according to the heterogeneity among the studies. The between-study heterogeneity was tested using the χ² test and the I² statistic, and funnel plots were used to evaluate any publication bias.

Results: We included five trials (four non-randomized trials and one randomized controlled trial) with a total of 1250 participants. The analyses showed a significant preventive effect on the recurrences of BPPV (RR = 0.37; 95% CI = 0.18-0.76; p = 0.007 with the random-effects model) with supplementation of vitamin D. Although a considerable heterogeneity was detected among the studies, the sensitivity analyses showed the reliability and stability of our results.

Conclusions: Vitamin D supplementation provides a benefit for secondary prevention of BPPV. Supplementation of vitamin D should be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal.

Keywords: BPPV; Calcium; Prevention; Vertigo; Vitamin D.

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References

1. Kim HJ LJ, Choi JY, Kim JS Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. J Neurol (in press). doi:10.1007/s00415–020–09831–2
1. Kim JS, Zee DS (2014) Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 370(12):1138–1147. https://doi.org/10.1056/NEJMcp1309481 - DOI - PubMed
1. Jeong SH, Kim JS, Shin JW, Kim S, Lee H, Lee AY, Kim JM, Jo H, Song J, Ghim Y (2013) Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 260(3):832–838. https://doi.org/10.1007/s00415-00012-06712-00412 (Epub 02012 Oct 00425) - DOI - PubMed
1. Buki B, Ecker M, Junger H, Lundberg YW (2013) Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses 80(2):201–204. https://doi.org/10.1016/j.mehy.2012.1011.1029 (Epub 2012 Dec 1014) - DOI - PubMed
1. Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS (2015) Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol 272(9):2249–2253. https://doi.org/10.1007/s00405-014-3175-3 - DOI - PubMed

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[1] Kim HJ LJ, Choi JY, Kim JS Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. J Neurol (in press). doi:10.1007/s00415–020–09831–2

[2] Kim HJ LJ, Choi JY, Kim JS Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. J Neurol (in press). doi:10.1007/s00415–020–09831–2

[3] Kim JS, Zee DS (2014) Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 370(12):1138–1147. https://doi.org/10.1056/NEJMcp1309481 - DOI - PubMed

[4] Kim JS, Zee DS (2014) Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 370(12):1138–1147. https://doi.org/10.1056/NEJMcp1309481 - DOI - PubMed

[5] Jeong SH, Kim JS, Shin JW, Kim S, Lee H, Lee AY, Kim JM, Jo H, Song J, Ghim Y (2013) Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 260(3):832–838. https://doi.org/10.1007/s00415-00012-06712-00412 (Epub 02012 Oct 00425) - DOI - PubMed

[6] Jeong SH, Kim JS, Shin JW, Kim S, Lee H, Lee AY, Kim JM, Jo H, Song J, Ghim Y (2013) Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 260(3):832–838. https://doi.org/10.1007/s00415-00012-06712-00412 (Epub 02012 Oct 00425) - DOI - PubMed

[7] Buki B, Ecker M, Junger H, Lundberg YW (2013) Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses 80(2):201–204. https://doi.org/10.1016/j.mehy.2012.1011.1029 (Epub 2012 Dec 1014) - DOI - PubMed

[8] Buki B, Ecker M, Junger H, Lundberg YW (2013) Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses 80(2):201–204. https://doi.org/10.1016/j.mehy.2012.1011.1029 (Epub 2012 Dec 1014) - DOI - PubMed

[9] Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS (2015) Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol 272(9):2249–2253. https://doi.org/10.1007/s00405-014-3175-3 - DOI - PubMed

[10] Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS (2015) Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol 272(9):2249–2253. https://doi.org/10.1007/s00405-014-3175-3 - DOI - PubMed

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Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis

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Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis

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