Research Letter by Gregory T. Whitman, MD; Robert W. Baloh, MD
Benign paroxysmal positional vertigo (BPPV) occurs when otoconia of the utricular macula become dislodged and freely floating otolithic debris moves into 1 or more of the semicircular canals (usually the posterior canal). This release of otoconia from the macula is most often idiopathic.1 However, it was recently found that in patients with BPPV, serum vitamin D levels are lower and prevalence of vitamin D deficiency is higher compared with controls.2 In addition, patients with BPPV have an abnormally high prevalence of osteoporosis,3 and BPPV recurrence is more common in those with osteoporosis compared with those with normal bone mineral density.4 Any analysis of a possible relationship between vitamin D deficiency and BPPV must account for the seasonality of serum vitamin D level. A previous investigation found that in Boston, Massachusetts, one’s serum vitamin D level falls during winter, reaching a low point each year in early spring (March-May).5 To explore for the possibility of a seasonality of BPPV, we assessed the number of BPPV visits seen at a hospital in Boston in March, April, and May and compared this with the number of visits during the remaining months of the year.
Source: The JAMA Network