BPPV: dizziness may come from ear problem

A woman presses her hands against her forehead after feeling dizzy. According to data from the National Health Insurance Service, 372,654 people were treated for BPPV in 2018. The number of patients was a 20.8 percent increase from 303,656 in 2014. Korea Times file

By Bahk Eun-ji

Office worker Kim Jae-won, 35, suddenly fainted in the morning a few weeks ago after feeling very dizzy. He was not that worried in the first place, because he drank soju and beer the night before and hit his head on the edge of his bed.

“I got a bump on the right side of my head and thought it was nothing serious,” Kim said.

And then the next morning, the world was spinning around and he could not even sit.

“I tried to stand up, but fell down again. I began to worry that I had a serious disease such as anemia or a brain tumor, but it turned out to be a few tiny calcium crystals in my ear,” Kim said.

A loss of balance often occurs due to a problem with the signals the ear sends to the brain. These usually control the sense of balance and spatial awareness, but if a person has a condition that affects the brain or inner ear, they may experience a loss of balance, spinning sensations, unsteadiness, or dizziness.

The condition, called benign paroxysmal positional vertigo (BPPV), or otolithiasis, can be frightening, when it takes people by surprise. Moreover, the dizziness and nausea prevents people from working or doing normal activities.

Doctors say a layer of calcium crystals are located in the ear to control physical balance, but if they are dislodged and flow with the fluid in the ears, they accidentally enter one of the three narrow semicircular canals.

“At the root of the problem are the tiny calcium crystals that sense gravity, found within the chambers of the inner ear,” said Prof. Jung Joon-hee of the National Health Insurance Service (NHIS) Ilsan Hospital.

Although anyone can develop BPPV at any age, the condition usually affects people over the age of 50. BPPV is also more common among women than men.

According to data from the NHIS, 372,654 people were treated for BPPV in 2018, a 20.8 percent increase from 303,656 in 2014.

Among last year's patients, 264,539 were women, taking up 71 percent. Especially older women were vulnerable, with 1.8 percent of all women aged over 50 being treated for BPPV.

“Why women and the elderly are more vulnerable is unknown yet. But recent studies show many BPPV patients also have osteoporosis, we suspect the hormone change and decrease in bone density among women after menopause could be linked,” Jung said.

In many cases, BPPV seems to develop randomly, but a few conditions may cause or affect the illness including head injuryies, inner ear infections or diseases, lying down for a long time, diabetes and reduced blood flow.

Treatments for BPPV mainly focus on improving visual stability and reducing vertigo and dizziness. Stay still in an upright position when feeling dizzy as it will make the symptom disappear in a few minutes. If the symptoms often occur, the moving calcium crystals need to be placed back into their original position. In many cases, doctors directly put them back.