Independent Predictors of Recurrence of Vertigo Among Nigerians

  • OA Sogebi
  • EA Oyewole
Keywords: Audiological symptoms, Dizziness, Head and Neck Injury, Recurrence, Vertigo


Background: Recurrence of vertigo indicates a morbidity to the patient and a dilemma for the managing physician.

Objectives: To describe the characteristics of vertigo, document prevalence and explore the characteristics which could independently predict recurrence of vertigo.

Methods: A cross-sectional study of patients managed for vertigo in a tertiary facility was retrospectively done. Patients’ demographic and clinical characteristics, associations of vertigo, audiological symptoms, comorbid illnesses, and duration to achieve control of vertigo were recorded. Recurrence of vertigo was used to categorize the patients. The factors that were associated with recurrence on univariate analyses were evaluated as independent predictors of recurrence of vertigo.

Results: The 73 patients with a male-to-female ratio of 1:1.4 were aged 35 -78 (mean 56.6±9.9) years. The associated symptoms included body weakness (34.2%), audiological symptoms (38.4%), 27.4% had antecedent head and neck injury and vertigo was precipitated or aggravated by changes in the head and neck position in 63.0% Vertigo was controlled within 1 -7 (Median 2) days, 35.6% had a recurrence of vertigo. Age, the experience of nausea and vomiting, previous head and neck injury, presence of comorbidity, and long duration to achieve control of vertigo were significantly associated with recurrence of vertigo. All these factors except the presence of comorbidity could independently predict the recurrence of vertigo.

Conclusion: Vertigo is common in adult females, and mostly positional in type. About a third of patients may have a recurrence of vertigo. Age, especially above 57 years, nausea and vomiting, head and neck injury and prolonged period to control vertigo may independently predict recurrence of vertigo.


Della-Morte D, Rundek T. Dizziness and vertigo. Front Neurol Neurosci. 2012; 30: 22-25.

Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol. 2016; 137: 67-82.

Ogita H, Taura A, Funabiki K, Miura M, Ito J. Clinical and epidemiological study on inpatients with vertigo at the ENT Department of Kyoto University Hospital. Acta Otolaryngol Suppl 2010; 563: 34-38.

Sogebi OA, Ariba AJ, Otulana TO, Osalusi BS. Vestibular disorders in elderly patients; characteristics, causes and consequences. Pan Afr Med J 2014; 19: 146.

Wipperman J. Dizziness and vertigo. Prim Care 2014; 41: 115-131.

Alyono JC. Vertigo and dizziness: understanding and managing fall risk. Otolaryngol Clin North Am 2018; 51: 725-740.

Choi SJ, Lee JB, Lim HJ, Park HY, Park K, In SM, et al. Clinical features of recurrent or persistent benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2012; 919–924.

Argaet EC, Young AS, Bradshaw AP, Welgampola MS. Cerebellar arteriovenous malformation presenting with recurrent positional vertigo. J Neurol 2019; 266: 247-249.

Comacchio F, Guidetti G, Guidetti R, Mion M. Pneumolabyrinth and recurrent paroxysmal positional vertigo after traumatic stapes fracture. Ann Otol Rhinol Laryngol 2019; 128: 352-356.

Kunte H, Paul F, Pache F, Dörr J, Bellmann-Strobl J, Harms L, et al. Iridodonesis as a cause of recurrent vertigo. Neurology 2015; 85: 1353.

Messina A, Casani AP, Manfrin M, Guidetti G. Italian survey on benign paroxysmal positional vertigo. Acta Otorhinolaryngol Ital 2017; 37: 328-335.

Kim YH, Kim KS, Kim KJ, Choi H, Choi JS, Hwang IK. Recurrence of vertigo in patients with vestibular neuritis. Acta Otolaryngologica, 2011; 131: 1172-1177.

Courand PY, Serraille M, Grandjean A, Tilikete C, Milon H, Harbaoui B, et al. Recurrent vertigo is a predictor of stroke in a large cohort of hypertensive patients J Hypertens 2019; 37: 942-948.

Picciotti PM, Lucidi D, De Corso E, Meucci D, Sergi B, Paludetti G. Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience. Int J Audiol 2016; 55: 279-284.

Zhang XL, Zhang MJ, Liu DL, Zhang QF. Etiological characteristics analysis of 3137 outpatients with vertigo or dizziness in ENT department. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018; 32: 758-761.

Brodsky JR, Lipson S, Wilber J, Zhou G. Benign paroxysmal positional vertigo (BPPV) in children and adolescents: clinical features and response to therapy in 110 pediatric patients. Otol Neurotol 2018; 39: 344-350.

Ogun OA, Janky KL, Cohn ES, Buki B, Lundberg YW. Gender-based comorbidity in benign paroxysmal positional vertigo. PLoS One 2014; 9: e105546.

Magliulo G, Bertin S, Ruggieri M, Gagliardi M. Benign paroxysmal positional vertigo and post-treatment quality of life. Eur Arch Otorhinolaryngol 2005; 262: 627-630.

Sahyouni R, Moshtaghi O, Haidar YM, Mahboubi H, Moshtaghi A, Lin HW, et al. Vertigo in vestibular schwannoma patients due to other pathologies. Otol Neurotol 2017; 38: e457-e459.

Yuan Q, Yu L, Shi D, Ke X, Zhang H. Anxiety and depression among patients with different types of vestibular peripheral vertigo. Medicine (Baltimore) 2015; 94: e453.

Horii A, Kitahara T, Osaki Y, Imai T, Fukuda K, Sakagami M, et al. Intractable benign paroxysmal positioning vertigo: long-term follow-up and inner ear abnormality detected by three-dimensional magnetic resonance imaging. Otol Neurotol, 2010; 31: 250–255.

Balatsouras DG, Koukoutsis G, Fassolis A, Moukos A, Apris A. Benign paroxysmal positional vertigo in the elderly: current insights. Clin Interv Aging 2018; 13: 2251-2266.

Babac S, Djeric D, Petrovic-Lazic M, Arsovic N, Mikic A. Why do treatment failure and recurrences of benign paroxysmal positional vertigo occur? Otol Neurotol 2014; 35: 1105–1110.

Perez P, Franco V, Cuesta P, Aldama P, Alvarez MJ, Mendez JC. Recurrence of benign paroxysmal positional vertigo. Otol Neurotol 2012; 33: 437–443.

De Stefano A, Dispenza F, Suarez H, Perez-Fernandez N, Manrique-Huarte R, Ban JH, et al. A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo. Auris Nasus Larynx 2014; 41: 31–36.

Oyedepo SO, Adeyemi GA, Fayomi OSI, Fagbemi OK, Solomon R, Adekeye T, et al. Dataset on noise level measurement in Ota metropolis, Nigeria. Data Brief 2018; 22: 762-770.

Sogebi OA, Olusoga-Peters OO, Oluwapelumi O. Clinical and audiometric features of presbycusis in Nigerians. Afr Health Sci. 2013; 13: 886-892.

Sogebi OA, Oyewole EA, Mabifah TO. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome Ghana Med J 2018; 52: 34-40.

Zhu RT, Rompaey VV, Ward BK, Van de Berg R, Van de Heyning P, Sharon JD. The interrelations between different causes of dizziness: a conceptual framework for understanding vestibular disorders. Ann Otol Rhinol Laryngol. 2019; 128: 869-878.

Pisani V, Mazzone S, Di Mauro R, Giacomini PG, Di Girolamo S. A survey of the nature of trauma of post-traumatic benign paroxysmal positional vertigo. Int J Audiol. 2015; 54: 329-333.

Balatsouras DG, Koukoutsis G, Aspris A, Fassolis A, Moukos A, Economou NC, et al. Benign paroxysmal positional vertigo secondary to mild head trauma. Ann Otol Rhinol Laryngol. 2017; 126: 54-60.

Evans TH, Schiller LR. Chronic vestibular dysfunction as an unappreciated cause of chronic nausea and vomiting. Proc (Bayl Univ Med Cent). 2012; 25: 214-217.

Tan J, Deng Y, Zhang T, Wang M. Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension, Acta Oto-Laryngologica, 2017; 137: 482-484.

Okinaka Y, Sekitani T, Okazaki H, Miura M, Tahara T. Progress of the caloric response of vestibular neuronitis. Acta Otolaryngol Suppl 1993; 503: 18–22.

Yoon J, Lee JB, Lee HY, Lee BD, Lee CK, Choi SJ. Potential risk factors affecting repeated canalith repositioning procedures in benign paroxysmal positional vertigo Otol Neurotol 2018; 39: 206-211.

Original Research