The effect of serum vitamin D normalization in preventing recurrences of benign paroxysmal positional vertigo: A case-control study

Background: Benign paroxysmal positional vertigo (BPPV) is a condition with recurrent attacks in a significant proportion of patients. The present case- control study was conducted to assess the influence of serum vitamin D normalization on recurrent attacks of vitamin D deficient patients. Methods: Diagnosis of BPPV was made based on history and clinical examination and exclusion of other conditions. Serum 25-hydroxy vitamin D (25-OHD) was measured using ELISA method and a levels of < 20 ng/ml was considered a deficiency of vitamin D. Inclusion criteria were as follows: history of recurrent attacks and serum 25OHD<20. ng/ml. While the patients with history of trauma, surgery and chronic systemic diseases were excluded. The patients were classified into two groups: treatment and control, intermittently. Both groups received Epley rehabilitation therapy one session per week for 4 weeks but the treatment group received an additional supplement of 50.000 IU of vitamin D (cholecalciferol) weekly for two months to achieve serum 25-OHD >= 30 ng/ml and the study patients were followed-up for 6 months. Results: Twenty-seven patients were allocated to each group. At baseline, serum 25-OHD was similar (10.7 +/- 2.3 vs 11.41 +/- 1.9, P=0.23). At month 2, serum 25-OHD in the treatment group increased significantly to >= 30 ng/ml, whereas serum 25-OHD in the control group remained unchanged (34.2 +/- 3.3 vs 10.6 10.6 +/- 2.2 ng/ml, P=0.001). During the follow-up period, attacks of BPPV in the treatment group decreased significantly compared with the control group (14.8% vs 96.3% OR= 0.18, P=0.001). Conclusion: The findings of this study indicate that the normalization of serum vitamin D significantly reduces BPPV recurrences.