Meta-analysis of the therapeutic effects of traumatic BPPV and idiopathic BPPV

By
Yifei Fu
Zhibin Zhao
June 9, 2026
0 min

Frontiers In Neurology

Overview

This systematic review evaluates the treatment efficacy and prognosis differences between traumatic benign paroxysmal positional vertigo (t-BPPV) and idiopathic BPPV (i-BPPV). Findings indicate that t-BPPV has significantly poorer outcomes, including higher recurrence rates and repositioning difficulties.

Background

Benign paroxysmal positional vertigo (BPPV) is a prevalent vestibular disorder that significantly impacts patients' quality of life. Understanding the differences in treatment outcomes between t-BPPV and i-BPPV is crucial for optimizing management strategies. This study addresses the need for high-level evidence to guide clinical practice in treating these distinct forms of BPPV.

Data Highlights

Outcome	RR (95% CI)	p-value
Recurrence Rate	3.39 (3.07–3.74)	< 0.00001
Repositioning Difficulty	3.05 (2.74–3.40)	< 0.00001
Treatment Efficacy	0.87 (0.84–0.90)	< 0.00001
Multi-Semicircular Canal Involvement	2.91 (1.55–5.47)	0.0009
Bilateral BPPV Incidence	3.37 (1.86–6.10)	< 0.00001

Key Findings

t-BPPV has a significantly higher recurrence rate compared to i-BPPV (RR = 3.39).
Patients with t-BPPV experience greater repositioning difficulty (RR = 3.05).
The treatment efficacy for t-BPPV is lower than for i-BPPV (RR = 0.87).
There is a higher proportion of multi-semicircular canal involvement in t-BPPV (RR = 2.91).
t-BPPV shows an elevated incidence of bilateral BPPV (RR = 3.37).

Clinical Implications

Clinicians should recognize that t-BPPV presents unique challenges compared to i-BPPV, necessitating tailored management strategies. Long-term follow-up and personalized interventions are essential for improving outcomes in patients with t-BPPV.

Conclusion

The findings underscore the need for differentiated treatment approaches for t-BPPV due to its poorer prognosis compared to i-BPPV. Enhanced understanding of these differences can lead to better patient management and care.