Benign Paroxysmal Positional Vertigo in Older Women May be Related to Osteoporosis and Osteopenia

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Abstract
Benign paroxysmal positional vertigo (BPPV), so-called canalolithiasis and cupulolithiasis, usually occurs after head trauma or viral vestibular neuritis. In many cases, the cause remains obscure, and it often affects women more than 50 years old. The goal of this work was to study a possible relationship between BPPV and osteopenia or osteoporosis. Thirty-two women, whose ages ranged from 50 to 85 years (median age, 69 years), who had BPPV and were free of any other otoneurologic history, were selected. The diagnosis of osteopenia or osteoporosis was confirmed by a bone mineral density measurement made with dual x-ray absorptiometry of spine and hip (T-score). The BPPV was unilateral in 26 patients and bilateral in 6 patients. Our results showed osteopenia or osteoporosis in 24 of the 32 patients (75%) with BPPV. The T-scores were compared in 3 age groups to those of 83 healthy women. The patients with BPPV had a significantly lower (p < .026) T-score in all groups. Possible pathophysiological mechanisms are discussed to explain the apparent correlation between BPPV and osteopenia or osteoporosis.