[Benign paroxysmal positional vertigo]

[Various types of vertigo and balance disorders in patients with Meniere's disease]

Vertigo and balance disorders in Meniere's disease (MD) may have various etiology. The aim of the review is discussing pathogenetic mechanisms of the typical vertiginous paroxysms in MD, resulting from endolymphatic hydrops as well as analysis of etiology, pathogenesis, clinical course and basic treatment of paroxysmal and permanent forms of vertigo and balance disorders, caused by other conditions, associated with MD. We discussed the course of MD complicated by vestibular migraine, benign positional paroxysmal vertigo, functional dizziness, bilateral vestibulopathy and vestibular drop-attacks.

[The impairment of bone-mineral metabolism in the development of benign paroxysmal positional vertigo]

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of systemic vertigo in clinical practice. The results of recent research demonstrated the decrease of bone mineral density, level of vitamin D and estrogen in blood serum in patients with BPPV. In summary these data points at the relationship between osteoporosis/osteopenia and BPPV. This association is most obvious in menopausal women and in those with recurrent BPPV. Patients with recurrent BPPV should undergo investigation for osteoporosis/osteopenia. Treatment of bone-mineral metabolism allows decreasing the frequency of BPPV recurrence, however more research is needed in this area.

[A role of vascular risk factors in the development of peripheral vestibulopathy]

The development of peripheral vestibular disorders are often thought to be associated with vascular mechanisms, taking into account terminal type of inner ear blood supply and other predisposing factors. A number of studies indicates a high frequency of vascular risk factors in the patients with vestibular neuronitis and benign paroxysmal positional vertigo (BPPV). According to other results, migraine is widely spread among patients with Meniere's disease and BPPV. However currently there is no evidence for casual relationship between vascular factors and development of peripheral vestibulopathy. The only exclusion is labyrinthine infarction, which develops as a result of posterior circulation disorder. More research is needed in this area.