Abstract：
OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) can be treated successfully in most cases. However, recurrences are common. We aimed to prospectively investigate demographic and clinical risk factors for BPPV recurrence. Our second aim was to investigate whether seasonality affects recurrences.
METHODS: We recruited adult Dutch patients presenting at our dizziness clinic with a diagnosis of definite or possible BPPV for a prospective observational study with 1-year follow-up. Factors collected from patient history and questionnaires were age, sex, ethnicity, previous treatment for BPPV, duration of BPPV symptoms, number of treatment sessions for the initial BPPV episode, the affected canal, recent head trauma, and a history of vestibular neuritis, Menière\'s disease, (vestibular) migraine, gout, diabetes mellitus, and chronic renal failure. Factors derived from blood samples were uric acid, glycated hemoglobin, and 25-hydroxyvitamin D.
RESULTS: We included 139 subjects with a mean age of 65 (SD, 13) years, of whom 70% was female. A total of 48 subjects (34.5%) suffered from at least one recurrence during the 1-year follow-up. Independent risk factors for recurrence of BPPV were \"multiple treatment sessions for the initial BPPV episode\" (incidence rate ratio, 1.74; 95% confidence interval 1.06-2.85; p = 0.027) and history of gout (incidence rate ratio, 1.90; 95% confidence interval, 1.01-3.57; p = 0.045).
CONCLUSIONS: One-third of patients presenting in a tertiary dizziness clinic develop at least one recurrence of BPPV within 1 year. Multiple treatment sessions and a history of gout are independent risk factors for recurrence.
METHODS: We recruited adult Dutch patients presenting at our dizziness clinic with a diagnosis of definite or possible BPPV for a prospective observational study with 1-year follow-up. Factors collected from patient history and questionnaires were age, sex, ethnicity, previous treatment for BPPV, duration of BPPV symptoms, number of treatment sessions for the initial BPPV episode, the affected canal, recent head trauma, and a history of vestibular neuritis, Menière\'s disease, (vestibular) migraine, gout, diabetes mellitus, and chronic renal failure. Factors derived from blood samples were uric acid, glycated hemoglobin, and 25-hydroxyvitamin D.
RESULTS: We included 139 subjects with a mean age of 65 (SD, 13) years, of whom 70% was female. A total of 48 subjects (34.5%) suffered from at least one recurrence during the 1-year follow-up. Independent risk factors for recurrence of BPPV were \"multiple treatment sessions for the initial BPPV episode\" (incidence rate ratio, 1.74; 95% confidence interval 1.06-2.85; p = 0.027) and history of gout (incidence rate ratio, 1.90; 95% confidence interval, 1.01-3.57; p = 0.045).
CONCLUSIONS: One-third of patients presenting in a tertiary dizziness clinic develop at least one recurrence of BPPV within 1 year. Multiple treatment sessions and a history of gout are independent risk factors for recurrence.
摘要：
目的：良性阵发性位置性眩晕（BPPV）在大多数情况下可以成功治疗。然而,复发是常见的。我们旨在前瞻性调查BPPV复发的人口统计学和临床危险因素。我们的第二个目的是调查季节性是否影响复发。
方法：我们招募了在我们的头晕诊所诊断为明确或可能的BPPV的荷兰成年患者，进行为期1年的前瞻性观察研究。从患者病史和问卷中收集的因素是年龄，性别,种族,以前对BPPV的治疗，BPPV症状的持续时间，初始BPPV发作的治疗次数，受影响的运河,最近头部外伤,有前庭神经炎病史,梅尼埃病,（前庭）偏头痛，痛风,糖尿病,慢性肾功能衰竭.来自血液样本的因素是尿酸，糖化血红蛋白,和25-羟基维生素D。
结果：我们包括139名平均年龄为65岁的受试者（SD，13）年，其中70%是女性。在1年的随访中，共有48名受试者（34.5％）至少有一次复发。BPPV复发的独立危险因素是“初次BPPV发作的多次治疗”（发生率比，1.74；95%置信区间1.06-2.85；p=0.027）和痛风病史（发病率比，1.90；95%置信区间，1.01-3.57；p=0.045）。
结论：在三级头晕门诊就诊的患者中，有三分之一在1年内出现至少一次BPPV复发。多次治疗和痛风病史是复发的独立危险因素。
方法：我们招募了在我们的头晕诊所诊断为明确或可能的BPPV的荷兰成年患者，进行为期1年的前瞻性观察研究。从患者病史和问卷中收集的因素是年龄，性别,种族,以前对BPPV的治疗，BPPV症状的持续时间，初始BPPV发作的治疗次数，受影响的运河,最近头部外伤,有前庭神经炎病史,梅尼埃病,（前庭）偏头痛，痛风,糖尿病,慢性肾功能衰竭.来自血液样本的因素是尿酸，糖化血红蛋白,和25-羟基维生素D。
结果：我们包括139名平均年龄为65岁的受试者（SD，13）年，其中70%是女性。在1年的随访中，共有48名受试者（34.5％）至少有一次复发。BPPV复发的独立危险因素是“初次BPPV发作的多次治疗”（发生率比，1.74；95%置信区间1.06-2.85；p=0.027）和痛风病史（发病率比，1.90；95%置信区间，1.01-3.57；p=0.045）。
结论：在三级头晕门诊就诊的患者中，有三分之一在1年内出现至少一次BPPV复发。多次治疗和痛风病史是复发的独立危险因素。
