Magnetic resonance imaging predicts chronic dizziness after benign paroxysmal positional vertigo

Objectives We aimed to evaluate the clinical implications of magnetic resonance imaging (MRI) findings in patients with benign paroxysmal positional vertigo (BPPV). Methods A total of 120 patients diagnosed with BPPV completed MRI at the emergency room between December 2012 and June 2015 and met our criteria for inclusion in this study. Epidemiologic characteristics, the results of audio-vestibular testing, and MRI findings were retrospectively analyzed. Results The most common findings were white matter hyperintensities (70.0%), sinusitis (34.2%), and brain atrophy (25.0%). There were no significant differences in MRI findings or epidemiologic characteristics according to BPPV subtype (p > 0.05). A multiple regression analysis revealed that BPPV recurrence (odds ratio, 6.88; 95% confidence interval, 1.67–34.48; p = 0.009) and brain atrophy (odds ratio, 4.39; 95% confidence interval, 1.11–21.28; p = 0.036) were positively associated with dizziness lasting longer than 3 months. Conclusion Brain atrophy was independently associated with long-lasting dizziness after BPPV. Although the mechanism is unclear, brain atrophy may have relevance to otoneurotologic disease-related changes in brain structure.