Document Type : Review article


1 Department of Surgery/Otolaryngology, College of Medicine, University of Anbar, Anbar, Iraq.

2 Department of Biochemistry College of Medicine, University of Anbar, Anbar, Iraq.

3 Department of Otolaryngology, Hamad Medical Corporation, Faculty of Medicine, Qatar University, Qatar.

4 Al-Emadi Hospital, Qatar


Benign paroxysmal positional vertigo (BPPV) is a short-lived attack of rotatory vertigo provoked by certain head movements. The most acceptable theories for its pathogenesis are canalithiasis and cupulolithiasis as a result of the detachment of otoconia from the otolithic membrane. Although canal repositioning maneuvers resolve BPPV, recurrence is a common feature. During the last two decades, there is a revolution in research in understanding many aspects of this
disorder. The advanced age, female gender, migraine, Meniere’s disease, trauma, and infection are recognized examples of the BPPV causes. Vitamin D deficiency or insufficiency is considered a risk factor for the occurrence and recurrence of the disease as indicated by many investigations. Therefore, estimation of vitamin D serum level in all subjects with BPPV is highly recommended. In addition to canal repositioning procedures such as the Epley maneuver, vitamin D
supplementation in patients with deficient or insufficient vitamin D is the best treatment for primary BPPV.
In this review, we discussed the updating knowledge of the risk factors of BPPV as an initiator for the disease or a risk factor for
its recurrence.


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