Benign paroxysmal positional vertigo without dizziness is common in people presenting to falls clinics

Susan Hyland; Lyndon J Hawke; Nicholas F Taylor

doi:10.1080/09638288.2024.2320271

Benign paroxysmal positional vertigo without dizziness is common in people presenting to falls clinics

Disabil Rehabil. 2024 Feb 24:1-6. doi: 10.1080/09638288.2024.2320271. Online ahead of print.

Authors

Susan Hyland^{1

2}, Lyndon J Hawke^{1

3}, Nicholas F Taylor^{1

3}

Affiliations

¹ Allied Health Clinical Research Office and Angliss Hospital Falls and Balance Clinic Eastern Health, Melbourne, Australia.
² Monash Health, Kingston Specialist Clinics, Melbourne, Australia.
³ School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.

PMID: 38400731
DOI: 10.1080/09638288.2024.2320271

Abstract

Purpose: To determine the prevalence of benign paroxysmal positional vertigo without dizziness, a treatable falls risk factor in people attending outpatient falls clinics.

Methods: Over 6 years, 618 people at risk of falls attending 2 falls clinics were assessed for benign paroxysmal positional vertigo, whether dizzy or non dizzy. Data regarding demographics, canal location of positive tests and comorbidities were collected from medical records.

Results: Thirty-nine percent (238) of people with falls risk tested positive for benign paroxysmal positional vertigo; 62 (26%) or 1 in 4 of those testing positive were not dizzy. Thirty-nine of 104 (38%) testing positive for single canal benign paroxysmal positional vertigo and twenty-four of 134 (18%) testing positive for multiple canal benign paroxysmal positional vertigo were not dizzy. Comorbidities were common for all with falls risk but did not differentiate for benign paroxysmal positional vertigo on testing.

Conclusions: Benign paroxysmal positional vertigo is common in people attending falls clinics and contributes to falls risk. Dizziness is common in BPPV though 26% or 1 in 4 people testing positive were not dizzy and would be missed without mandatory testing. Testing should also include all semicircular canals as multiple-canal involvement was high.

Keywords: Benign paroxysmal positional vertigo; accidental falls; dizziness; semicircular canals; vestibular rehabilitation.

Plain language summary

Benign paroxysmal positional vertigo is a common and treatable falls risk factor, however screening for benign paroxysmal positional vertigo in people who fall usually only occurs if they are dizzy.1 in 4 people with falls risk who have benign paroxysmal positional vertigo do not report symptoms of dizzinessScreening for benign paroxysmal positional vertigo in all people who fall whether dizzy or not, is required to comprehensively identify and treat benign paroxysmal positional vertigoAll semicircular canals should be screened for benign paroxysmal positional vertigo as the incidence of multiple-canal involvement is high.