When the World Suddenly Starts to Spin: Suspected Stroke Turns Out to Be BPPV

[Financial News] Recently, a woman in her 60s, identified as A, felt severe dizziness as if the world were spinning when she got up in the morning. Fearing a cerebrovascular disease such as a stroke, she went to the emergency room and visited a neurology clinic before finally being diagnosed with BPPV by an otolaryngologist.
As in A's case, people who experience sudden dizziness often first think of a brain disorder. However, one of the most common causes of sudden rotational dizziness, or vertigo, is BPPV.
According to health care big data from the Health Insurance Review and Assessment Service, about 500,000 patients were treated for BPPV in 2024. The condition is known to occur frequently among women in their 50s and 60s.
Researchers say this may be related to hormonal changes after menopause, reduced bone density, and changes in calcium and vitamin D metabolism.
Lee Il-woo, head of the otolaryngology department at On Hospital in Busan, explained, "BPPV is a disorder in which otoconia, calcium crystals that should remain in the otolith organs of the inner ear, become dislodged and move into the semicircular canals, where they stimulate the nerves." He added, "It is characterized by strong rotational dizziness lasting less than a minute, along with vomiting and nausea, when moving the head, getting up from a lying position, or turning the head."
If diagnosed accurately, BPPV can be improved relatively quickly through canalith repositioning, a procedure that returns the otoconia to their original position.
The problem, however, is the high recurrence rate. Depending on the study, recurrence after treatment has been reported at 5% to 47%, making it a condition known for frequent relapse.
That is why lifestyle management after treatment is very important.

Lee advised, "If dizziness remains after treatment, be careful because sudden changes in posture can increase the risk of falling." He added, "When getting up in the morning, sit slowly for about 30 seconds to steady yourself before standing. It is also better not to bend your head too far when washing your hair or taking a shower."
Studies also suggest that if a person has vitamin D deficiency, proper supplementation may help reduce the recurrence of BPPV. Therefore, it is a good idea to check vitamin D levels if necessary and consult medical staff about appropriate supplementation.
If dizziness persists after hospital treatment or balance problems continue, vestibular rehabilitation or self-exercises may be performed.
A representative self-exercise is the Brandt-Daroff exercise.
The exercise involves sitting upright, turning the head 45 degrees to one side, then quickly lying down on that side. Once the dizziness subsides, the patient sits up again. The same movement is repeated on both sides. However, the frequency and number of repetitions should be guided by medical staff depending on the patient's condition.
Lee emphasized, "BPPV is a condition that can recover quickly if it is diagnosed properly at an early stage." He added, "When sudden dizziness strikes, do not panic. Visit a specialist, identify the exact cause, and combine proper lifestyle habits with rehabilitation exercises. That is the best way to protect ear health."
He also advised, "If sudden dizziness is accompanied by slurred speech, weakness in the arms or legs, difficulty walking, or severe headache, a central nervous system disorder such as stroke cannot be ruled out. In that case, you should go to the hospital immediately."
[email protected] Byeon Ok-hwan Reporter