Objective: To evaluate the prevalence of benign paroxysmal positional vertigo (BPPV), defined as positionally induced nystagmus (PIN) with associated symptoms on provocative testing, in the young healthy adult population. Design: A prospective, cohort, screening study. Setting: A community-based hospital located in a small midwestern city with a greater metropolitan population of approximately 125,000. Participants: One hundred ninety-eight young adults (99 men and 99 women), ages 18-34 years and not being treated for dizziness or balance problems, were recruited from November 2009 to April 2010. Methods: The participants completed questionnaires that detailed demographics, medical and surgical history, sports and/or activity participation history, and baseline symptoms commonly associated with BPPV. The participants were screened for inclusion with an ocular motor assessment in room light, followed by a vestibular positional assessment for BPPV with infrared camera-equipped goggles recorded on digital video disk. Main Outcome Measurement: The prevalence of BPPV, defined as PIN, along with symptoms in study participants. Results: The prevalence of BPPV was 9% in this young adult population. Symptoms during testing were reported in 14% of all subjects (22% of women, 5% of men). Of 22 women who reported symptoms, 12 had PIN (P=.519), whereas the 5 men who reported symptoms all had PIN (P=.001). PIN, characteristic of that seen in BPPV (with or without associated symptoms), was identified in 53% of subjects, with 43% of subjects having posterior canal involvement, 10% having anterior canal involvement, and 8% having horizontal canal involvement. Eleven percent of subjects had bilateral semicircular canal involvement. Conclusion: Nine percent of our young adult subjects were diagnosed with previously unrecognized BPPV, with provoked symptoms of dizziness, headache, nausea, or imbalance, symptoms that may cause significant physical and psychosocial limitations if left untreated. This is an important finding because BPPV is an often-overlooked diagnosis that has a known, very effective treatment.
Bibliographical noteFunding Information:
We thank Jonean Schroeder, BS, for coordinating data collection and Erin Hussey, DPT, Matt Haberl, DPT, Polly Davenport-Fortune, RN, NP, and the University of Wisconsin-La Crosse pre-Physical Therapy student group of 2009-2010 for assisting with screening. We also thank Andrew J. Borgert, PhD, for assistance with statistical analysis, and thank Peter Haack for valuable computer assistance. We thank Synapsys Inc for providing the equipment used in this study, including 3 Dell laptop computers, VNS 3X monocular infrared cameras, eye covers, goggles, GBX video converters, and external recording cameras. We also thank the Gundersen Medical Foundation for supporting the project by sponsoring the gas cards.