Clinical features of secondary BPPV: A nation-wide multicenter study

Seunghee Na¹, Eun-Ju Jeon², Min-Beom Kim³, Jung-Yup Lee³, Chang-Hee Kim⁴, Sung Il Nam⁵, Hyun Ah Kim⁶, Hyung Lee⁶, Ji-Soo Kim⁷, Jeong-Yoon Choi⁷, Min-Ku Kim⁷, Ji-Yun Park⁸, Jeon Mi Lee⁹, Eunjin Kwon¹⁰, Seong-Hae Jeong¹⁰, Sung-Kwang Hong¹¹, Hyo-Jeong Lee¹¹, Jae-Yong Byun¹², Myung Hoon Yoo¹³, Seok Min Hong¹², Tae-Kyeong Lee¹⁴, Sangwoo Lee¹⁴, Yun Ji Lee¹⁵, Kyu-Sung Kim¹⁶, Jae-Hyun Seo¹⁷, Sun-Uk Lee¹⁸, Eek-Sung Lee¹⁴, Hong Ju Park¹⁹

Affiliations

¹ Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
² Department of Otolaryngology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
³ Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
⁵ Department of Otorhinolaryngology, Keimyung University School of Medicine, Daegu, South Korea.
⁶ Department of Neurology and Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea.
⁷ Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea.
⁸ Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
⁹ Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
¹⁰ Department of Neurology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, South Korea.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
¹² Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, South Korea.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea.
¹⁴ Department of Neurology, Soonchunhyang University Hospital Bucheon, Bucheon, South Korea.
¹⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
¹⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Inha University Hospital, Incheon, South Korea.
¹⁷ Department of Otorhinolaryngology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
¹⁸ Department of Neurology, Korea University Medical Center, Seoul, South Korea.
¹⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

PMID: 40085797
DOI: 10.1177/09574271251319775

Multicenter Study

Clinical features of secondary BPPV: A nation-wide multicenter study

Seunghee Na et al. J Vestib Res. 2025 Jul.

. 2025 Jul;35(4):193-204.

doi: 10.1177/09574271251319775. Epub 2025 Mar 14.

Authors

Affiliations

¹ Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
² Department of Otolaryngology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
³ Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
⁵ Department of Otorhinolaryngology, Keimyung University School of Medicine, Daegu, South Korea.
⁶ Department of Neurology and Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea.
⁷ Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea.
⁸ Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
⁹ Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
¹⁰ Department of Neurology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, South Korea.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
¹² Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, South Korea.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea.
¹⁴ Department of Neurology, Soonchunhyang University Hospital Bucheon, Bucheon, South Korea.
¹⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
¹⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Inha University Hospital, Incheon, South Korea.
¹⁷ Department of Otorhinolaryngology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
¹⁸ Department of Neurology, Korea University Medical Center, Seoul, South Korea.
¹⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

PMID: 40085797
DOI: 10.1177/09574271251319775

Abstract

BackgroundBenign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, and its prevalence is substantial. While primary BPPV has been well studied, the understanding of secondary BPPV is still limited.ObjectiveTo investigate the prevalence and clinical characteristics of secondary BPPV in a national multicenter retrospective analysis.MethodsThe study involved a retrospective analysis of medical records from 17 institutions across South Korea, between January and June 2022. We evaluated clinical features, presumed etiologies, involvement of semicircular canals, response to canalith repositioning procedures (CRPs), presence of residual dizziness, recurrence, and results of auditory and vestibular function tests for both primary and secondary BPPV cases.ResultsOf the total 1363 BPPV cases, 14.5% (198 patients) were categorized as secondary BPPV. The most prevalent etiology for secondary BPPV was head trauma. Secondary BPPV was associated with a higher prevalence of comorbidities including diabetes and inner ear diseases. Patients with secondary BPPV demonstrated more frequent involvement of multiple semicircular canals, necessitated a greater number of CRPs for resolution, and experienced a higher incidence of residual dizziness compared to primary BPPV cases. Furthermore, secondary BPPV patients exhibited more frequent abnormalities in auditory and vestibular function tests.ConclusionsSecondary BPPV accounts for a significant proportion of BPPV cases, with distinct clinical characteristics compared to primary BPPV.

Keywords: Benign paroxysmal positional vertigo; canalith repositioning procedure; labyrinth diseases; recurrence; traumatic brain injuries.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Clinical features of secondary BPPV: A nation-wide multicenter study

Affiliations

Clinical features of secondary BPPV: A nation-wide multicenter study

Authors

Affiliations

Abstract

Conflict of interest statement

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MeSH terms

LinkOut - more resources

Full Text Sources

Medical