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Treatment for Dizziness and BPPV
Blog January 19, 2025

Treatment for Dizziness and BPPV

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director

Dizziness is common in patients visiting internal medicine departments, accounting for up to 5% of primary care clinic visits. However, diagnostic difficulties can arise because patients use the terms "dizziness" and "vertigo" to describe a wide range of sensations.

Incheon Dizziness/Vertigo

Since "dizziness" is a vague term, when a patient complains of dizziness, the priority should be to listen to a more detailed description of their symptoms. The first thing to distinguish when someone reports dizziness is whether their vision blacks out or if the world is spinning.

Patients may complain of dizziness and difficulty maintaining balance when sitting up, standing, or moving, or a sensation that the sky or ground is moving while walking. Other symptoms include dizziness even when staying still, feeling lightheaded as if about to faint, postural instability, feeling dizzy as if about to fall while walking, or fear described using the term "anxiety."

As dizziness is reported in various forms, we recommend a more thorough examination of its presentation. Dizziness can also be an early symptom of a stroke, so it is necessary to primarily rule out the possibility of a stroke, especially when it appears suddenly. A cautious approach is particularly important in elderly patients who experience sudden-onset dizziness, as it may suggest the possibility of a stroke.

The Most Common Type of Dizziness: Benign Paroxysmal Positional Vertigo (BPPV)

The most commonly observed type of dizziness is peripheral vertigo triggered by changes in body position, known as Benign Paroxysmal Positional Vertigo (BPPV). A significant number of cases involve experiencing BPPV. While symptoms often show improvement initially with canalith repositioning maneuvers, recurrence is not uncommon, so caution is advised.

Dix-Hallpike is a highly useful method for both diagnosing and treating BPPV.

Watch Dix-Hallpike video

In cases where symptoms do not improve well even with canalith repositioning maneuvers, or in various patterns of chronic dizziness such as Meniere's syndrome or vestibular neuritis (which are not BPPV), you can receive help from various traditional Korean medicine treatments.

Conclusion

Today, we briefly summarized BPPV and dizziness.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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