Benign paroxysmal positional vertigo and orthostatic hypotension

OBJECTIVE: The aim of this study was to investigate a possible correlation between post-benign paroxysmal positional vertigo (BPPV) dizziness and orthostatic hypotension (OH) using the head-up tilt test (HUTT). METHODS: Twenty-nine patients previously affected by BPPV and successfully underwent repositioning maneuvers were tested using the HUTT. RESULTS: Our data do not show a statistically significant relationship between OH and the persistence of balance disorders after recovery from BPPV; anyway the prevalence of OH in the overall sample (34%) and in subjects affected by balance disorders after recovery (40%), was higher than in the general population. INTERPRETATION: it is reasonable to hypothesize that OH plays a role in the genesis of orthostatic dizziness that patients commonly experience after recovery from BPPV. To improve the sensitivity of the HUTT, it would be advisable to use non-invasive continuous blood pressure monitoring. Although we feel that additional data are needed, we believe that the present work underlines the importance of considering anomalies of the autonomic system in the differential diagnosis of dizziness and could offer the basis for further studies about the role of sympathetic reflexes in those cases of persistence of symptoms after recovery from BPPV.