Recurrence of benign paroxysmal positional vertigo: risk factors and outcomes

OBJECTIVE: Benign paroxysmal positional vertigo is the most common peripheral vestibular disorder. It can recur despite successful maneuvers. While various risk factors for recurrence have been investigated, these remain controversial. The aim of this study was to identify potential risk factors for benign paroxysmal positional vertigo recurrence and contribute to the development of preventive treatment strategies. METHODS: The study involved 301 patients who presented to our clinic with dizziness and were diagnosed with benign paroxysmal positional vertigo between December 2019 and May 2022. Two groups, with and without benign paroxysmal positional vertigo recurrence, were compared in terms of age, gender, hypertension, diabetes mellitus, hyperlipidemia, cardiovascular disease, asthma, hypothyroidism, magnesium deficiency, vitamin D deficiency, vitamin B12 deficiency, and iron deficiency to investigate the effects of these factors on recurrence. RESULTS: Recurrence was observed in 38 (12.6%) of the 301 patients. No age or gender difference was determined between the groups. Univariate analysis showed that hypertension (55.3 vs. 29.3%; p=0.003), vitamin B12 deficiency (21.1 vs. 6.5%; p=0.007), hyperlipidemia (26.3 vs. 5.7%; p<0.001), and asthma (15.8 vs. 5.7%; p=0.035) were more common in patients with recurrence. Multivariate logistic regression analysis identified only hyperlipidemia as a risk factor, raising the risk of recurrence approximately 3.7-fold (OR 3.71; 95%CI 1.36–10.13; p=0.011). CONCLUSION: Consideration of underlying comorbidities and systemic factors, effective management of existing comorbidities, and individualized treatment strategies are crucial in order to reduce benign paroxysmal positional vertigo recurrence rates and improve patients’ quality of life. © 2026, Associacao Medica Brasileira. All rights reserved.