Objective To investigate the occurrence and risk factors of residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) 1 week after successful canalith repositioning procedure (CRP).

Methods Totally, 223 patients with BPPV who received successful CRP in the first visit in Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 2018 to June 2019 were followed up for 1 week. At the first diagnosis (W0) and one week (W1), vertigo/dizziness visual analogue scale (VAS) and dizziness handicap inventory (DHI) were evaluated, and GAD-7, PHQ-9, HAMA, and HAMD-17 were evaluated at W0. RD was defined as the dizziness VAS score >1 at W1. The baseline (W0) demographic and related clinical differences between patients with and without RD groups were compared, and the influencing factors of patients' short-term quality of life were investigated.

Results The incidence of RD was 50.67% (113/223) in BPPV patients one week (W1) after successful CRP. Compared with RD negative group, patients with RD positive group had a higher dizziness handicap inventory (DHI) score at W0 (P=0.009), among which functional score (DHI-F)(17.38±8.67 vs14.91±9.39, P=0.044) and emotional score (DHI-E)(42, 11.5 vs 40, 8, P=0.013) were significantly increased. There was no significant difference in age, gender, vertigo duration, involved semicircular canal, anxiety and depression scores between the two groups. Binary logistic regression analysis found that the DHI score >30 (OR=2.149, 95%CI 1.257-3.673, P=0.005) at W0 was an independent predictor of RD in patients with BPPV at 1 week. Stepwise linear regression showed that RD was the main factor influencing the quality of life in patients with BPPV 1 week after successful CRP (95% CI 10.346-16.661, P < 0.001).

Conclusions Nearly half of BPPV patients has RD 1 week after successful CRP. The DHI score >30 at the first diagnosis might increase the risk of short-term RD.