Benign Paroxysmal Positional Vertigo Associated With Meniere's Disease: Epidemiological, Pathophysiologic, Clinical, and Therapeutic Aspects

Objectives: We studied the demographic, pathogenetic, and clinical features of benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease. Methods: The medical records of patients with BPPV associated with Meniere's disease were reviewed. In all patients, results of a complete otolaryngological, audiological, and neurotologic evaluation, including nystagmography, were available. Patients with idiopathic BPPV were used as a control group. Results: Twenty-nine patients with both disorders were found and were compared with 233 patients with idiopathic BPPV. The patients with BPPV associated with Meniere's disease presented the following features, in which they differed from the patients with idiopathic BPPV: 1) a higher percentage of female patients; 2) a longer duration of symptoms; 3) common involvement of the horizontal semicircular canal; 4) a greater incidence of canal paresis; and 5) more therapeutic sessions needed for cure and a higher rate of recurrence. Conclusions: The BPPV associated with Meniere's disease differs from idiopathic BPPV in regard to several epidemiological and clinical features, may follow a different course, and responds less effectively to treatment.