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<p><span style="color: #00826a;"><strong>“Benign Paroxysmal Positional Vertigo (BPPV)”</strong></span> is one of the terms we are very familiar with and often say casually. However, in fact, <strong><span style="color: #00826a;">“vertigo”</span></strong> is not a disease but an important symptom. It is the sensation that the surroundings are spinning, causing dizziness and nausea. Most cases of vertigo not caused by brain abnormalities may be a sign of two major diseases: displaced otoliths in the inner ear and Meniere’s disease. These two diseases have different details and dangers, so we should understand and study them well to estimate which disease we might be at risk for and to properly prevent and take care of ourselves.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">Understanding What is Displaced Otoliths in the Inner Ear? (Benign Paroxysmal Positional Vertigo; BPPV) (Semicircular canal)</span><strong><span style="color: #00826a;"><br />
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<p style="color: #008080;"><span style="color: #000000;">Displaced otoliths in the inner ear is a condition caused by otoliths in the inner ear, located in the semicircular canals responsible for balance, becoming dislodged from their sac. Most of the time, the cause is unknown, but it may occur due to head trauma, sudden head movements, or intense amusement rides, which can cause the otoliths to dislodge. Otoliths naturally exist in everyone’s body and function as sensors for body movement. When these otoliths become dislodged from the inner ear, it causes vertigo.</span></p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How to recognize symptoms to be sure it is displaced otoliths in the inner ear?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p style="color: #008080;"><span style="color: #000000;">The key symptoms of displaced otoliths in the inner ear that we can observe are:</span></p>
<ul>
<li>Feeling dizzy immediately upon movement, with dizziness decreasing when sitting still</li>
<li>Dizziness lasts briefly, about 1 – 5 minutes</li>
<li>Both eyes twitch in the same direction, causing blurred vision which leads to the sensation of spinning</li>
<li>Normal hearing, no ear fullness or ringing</li>
</ul>
<p>This condition affects dizziness but is not related to the auditory nerve system. Therefore, there are no hearing abnormalities such as ear fullness or tinnitus.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How to treat displaced otoliths in the inner ear?</span><strong><br />
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<p style="color: #008080;"><span style="color: #000000;">In reality, displaced otoliths in the inner ear can sometimes resolve on their own, but this is rare. The treatment involves repositioning the dislodged otoliths back to their original place. Some lucky individuals may accidentally move the otoliths back by themselves, but most patients are not that fortunate and often do not know what they are suffering from, only experiencing frequent vertigo until they see a doctor. Once diagnosed, treatment involves head physical therapy, where the patient moves their head in specific positions to guide the otoliths back to their normal place. This is the most effective treatment and takes about 10 – 15 minutes.</span></p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How dangerous is displaced otoliths in the inner ear?</span><strong><span style="color: #00826a;"><br />
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<p style="color: #008080;"><span style="color: #000000;">Displaced otoliths in the inner ear is not a highly dangerous condition but it disrupts daily life. Most patients do not realize they have this condition and think it is just normal dizziness, so they do not seek treatment and continue to experience vertigo. If left untreated, it may cause dangerous accidents due to vertigo. However, if patients with displaced otoliths seek treatment, most can recover immediately. Some may experience recurrence, and for frequent recurrences, surgery may be considered to prevent otoliths from dislodging again. Therefore, to prevent danger and maintain a good quality of life, if you experience vertigo, you should promptly see a doctor for diagnosis and proper treatment.</span></p>
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<h4 style="color: #008080;"><span style="color: #00826a;">Meniere’s Disease: Another condition causing vertigo</span><strong><span style="color: #00826a;"><br />
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<p style="color: #008080;"><span style="color: #000000;">Meniere’s disease is a condition with unknown cause but is suspected to be due to abnormal excess fluid in the inner ear system, disturbing balance and affecting the auditory nerve. Factors triggering this condition include inappropriate dietary habits leading to excessive sodium intake. High-risk groups include those who consume very spicy or salty foods and those who regularly drink beer, liquor, or coffee. However, it also depends on individual body systems.</span></p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How to recognize symptoms to be sure it is Meniere’s disease?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p style="color: #008080;"><span style="color: #000000;">Since Meniere’s disease affects both the balance system and auditory nerve, its symptoms differ from displaced otoliths. Symptoms of Meniere’s disease include:</span></p>
<ul>
<li>Continuous vertigo lasting from 20 minutes to several hours</li>
<li>Severe dizziness all day, with patients often lying still and not moving</li>
<li>Ear fullness or reduced hearing</li>
<li>Ringing in the ears, such as humming or buzzing sounds, but not heartbeat sounds</li>
</ul>
<p>&nbsp;</p>
<p>It can be seen that the difference between Meniere’s disease and displaced otoliths is that Meniere’s disease includes ear-related symptoms such as ear fullness, hearing loss, and tinnitus, and the vertigo lasts longer. Displaced otoliths do not have these symptoms.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How is Meniere’s disease treated?</span><strong><span style="color: #00826a;"><br />
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<p style="color: #008080;"><span style="color: #000000;">Once a doctor confirms the diagnosis of Meniere’s disease, the treatment approach is <span style="color: #00826a;"><strong>“medication”</strong></span> to reduce the excess fluid in the ear back to normal. Most medications used are diuretics, similar to blood pressure medications that help increase urination, and medications to reduce dizziness.</span></p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How dangerous is Meniere’s disease?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p style="color: #008080;"><span style="color: #000000;">Meniere’s disease is more dangerous than displaced otoliths because it causes more severe dizziness and is harder to cure. Treatment takes longer and requires continuous follow-up, unlike displaced otoliths which can be cured simply by repositioning the otoliths.</span></p>
<p>&nbsp;</p>
<p>The danger of Meniere’s disease lies in the severe vertigo that may cause accidents. Therefore, when experiencing vertigo, do not ignore it or think it is just normal dizziness. You should see a doctor for accurate diagnosis and proper treatment. Meanwhile, when vertigo occurs, patients should find something to hold onto and sit down immediately. Do not force yourself to stand to prevent falls that could cause serious injuries, especially in the elderly.</p>
<p style="color: #008080;" align="center"><span style="color: #00826a;"><strong><em>“Frequent vertigo should not be ignored</em> </strong></span><br />
<span style="color: #00826a;"><strong><em>See a doctor for diagnosis promptly</em> </strong></span><br />
<span style="color: #00826a;"><strong><em>and treat yourself to regain</em> </strong></span><br />
<span style="color: #00826a;"><strong><em>your bright and healthy life again”</em></strong></span></p>
<p>&nbsp;</p>
<p align="right">
<p align="right"><span style="color: #00826a;"><strong>Dr. Naparat Jirawatnapolin</strong></span><br />
Specialist in Facial Plastic and Reconstructive Surgery<br />
Ear, Nose, and Throat Center<br />
Phyathai 3 Hospital</p>


Benign paroxysmal positional vertigo (BPPV) and Meniere's disease are two different inner ear conditions. Both have distinct details and levels of severity, so it is important to understand and study them well in order to assess which condition you might be at risk for and take appropriate action.

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