"Dizziness in the head"… It was a problem with the ear, a disease that targets women during the summer.

Sometimes my mom says she's feeling dizzy.

I need to carefully check if there is something wrong with my ear.

Hearing about people suffering from benign paroxysmal positional vertigo (BPPV) really sounds tough...

It's not easy to be healthy without getting sick.

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Learning about diseases that cause dizziness

 

The most common cause of dizziness is ear disease. Problems with the ear, which plays a role in maintaining body balance, such as benign paroxysmal positional vertigo and Meniere's disease, are involved. Let's learn about the two main conditions that cause dizziness with Professor Byun Jae-yong from the Department of Otolaryngology at Gangdong Kyunghee University Hospital.

Benign paroxysmal positional vertigo (BPPV) and Meniere's disease may appear similar, but they are completely different conditions. BPPV is a disorder caused by calcium carbonate crystals called otoconia, which normally reside in the utricle of the inner ear. For some reason, these otoconia become dislodged and enter the semicircular canals, which are part of the balance system, irritating the nerves and causing dizziness. When the head moves or changes position, the dislodged otoconia shift, stimulating the nerves and resulting in vertigo. Most symptoms are very brief, and the dizziness subsides when the body stops moving. The otoconia do not affect the cochlea, so they do not cause hearing problems such as hearing loss, tinnitus, or aural fullness.

Benign paroxysmal positional vertigo does not cause hearing problems.
Benign paroxysmal positional vertigo (BPPV) is a disease with an unknown cause. The causes are often inferred by examining which gender and age groups have higher incidences. According to the Health Insurance Review & Assessment Service, approximately 48% of all BPPV patients in 2023 were women over middle age (50 years and older), representing the highest proportion. Based on this data and the fact that ear stones are calcium deposits, there is strong support for a correlation with diseases such as vitamin D deficiency or osteoporosis. Professor Byun Jae-yong explains, "Additionally, ear stones can fall when blood circulation is not smooth," and "since blood circulation often deteriorates after middle age, there is a suspected link, and viral infections are also considered one of the causes."

Benign paroxysmal positional vertigo (BPPV) is treated with repositioning maneuvers that move the otoliths, which have fallen into the semicircular canals and cause dizziness, back to the utricle, a location that does not stimulate the nerves. To perform the repositioning maneuver, it is most important to confirm the location of the otoliths. This is done through the Dix-Hallpike test, which involves stimulating the semicircular canals and reading eye movement signals to determine the position of the otoliths. About 95% of patients who undergo the repositioning maneuver experience symptom improvement, but in very rare cases, treatment involves semicircular canal occlusion surgery to prevent the otoliths from touching the nerves.

 

Menier's disease, dizziness accompanied by hearing impairment

Menier's disease occurs when the endolymph fluid in the cochlea and semicircular canals of the inner ear increases for various reasons, raising the pressure inside the ear. Professor Byun explained, "Menier's disease is accompanied by audiological symptoms such as hearing loss and tinnitus," and "Unlike benign paroxysmal positional vertigo, it is caused by increased pressure in the ear, so symptoms do not disappear even if the body remains still." Dizziness accompanied by hearing loss and tinnitus can last for more than 20 minutes, and in severe cases, up to 3 to 4 hours.

The exact cause of Meniere's disease has not been clearly identified. Like benign paroxysmal positional vertigo, it is more common in women, accounting for about 70%. Meniere's disease is believed to be associated with autoimmune disorders. During hot summer months, extra caution should be taken with Meniere's disease. It occurs due to an increase in endolymphatic fluid, and there are studies indicating that the prevalence increases in hot weather when the endolymphatic fluid tends to increase relatively. Currently, many studies are ongoing to determine the causes of Meniere's disease.

The treatment goal for Meniere's disease is to reduce the amount of endolymphatic fluid. It is mainly controlled using diuretics. By regulating endolymphatic fluid with diuretics and improving lifestyle habits to limit salt intake (less than 1.5 grams per day), symptoms can be alleviated. Since there is also a consistent association with migraines, maintaining regular eating and sleeping habits, managing overexertion, and stress are necessary. Professor Byun emphasized, "Both Meniere's disease and benign paroxysmal positional vertigo have high recurrence rates," and "if you have experienced either once, ongoing management is essential."