Seasonality in benign paroxysmal positional vertigo: a systematic review

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness with a lifetime prevalence of up to 2.4%. However, pathophysiology and risk factors for BPPV have not yet been fully clarified.

OBJECTIVE: To systematically examine and discuss seasonal variation in BPPV and the possible relationship between BPPV and climatic variables such as temperature, atmospheric pressure, solar exposure factors, and humidity.

METHODS: A systematic search was conducted in PubMed and Embase based on a search string with main components BPPV, seasonal variation and climate. Search results were only included if they met the predetermined inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and the AXIS tool was used to assess the quality of the included articles.

RESULTS: 12 studies with a total of 18 507 subjects were included. Nine out of 11 studies showed seasonal variation in BPPV, with the majority of these showing an increase in BPPV during the winter months. Four out of six studies showed a negative correlation between temperature and BPPV, three out of four studies showed a positive correlation between atmospheric pressure and BPPV, while three out of five studies showed a negative correlation between solar exposure factors and BPPV. Three out of three studies showed no correlation between humidity and BPPV.

CONCLUSIONS: Most of the existing literature indicates that there is a seasonal variation in BPPV, with a predominance of BPPV in the winter months. However, the existing literature is only suggestive of the relationship between the examined climatic variables and BPPV.