Still dizzy 6 months after repositioning for otolith disorder

In general, if dizziness persists for six months after repositioning treatment for benign paroxysmal positional vertigo (BPPV), it may be due to incomplete treatment, psychological factors, incomplete recovery of vestibular function, poor inner ear microenvironment, hypertension, or other factors. Patients are advised to follow medical advice and receive symptomatic treatment accordingly. The specific analysis is as follows:

1. Incomplete Treatment

If the patient previously suffered head trauma, BPPV may be triggered, leading to various abnormal symptoms such as vertigo, nausea, and vomiting. These symptoms can usually be relieved through manual repositioning maneuvers under a doctor's guidance. If the repositioning was not successfully completed during treatment, patients may continue to experience similar symptoms afterward. In such cases, timely repeat repositioning procedures should be performed.

2. Psychological Symptoms

When BPPV occurs, patients may experience significant psychological stress, fear, or anxiety, which can contribute to feelings of dizziness. It is recommended that patients maintain a positive mindset, stay relaxed, and manage stress appropriately, which may help alleviate symptoms.

3. Vestibular Function Has Not Fully Recovered

Although BPPV may have been successfully treated, the vestibular system may not yet have fully recovered. As a result, patients may still experience dizziness. This requires time for natural recovery and is considered a normal phenomenon; patients need not be overly concerned.

4. Poor Inner Ear Microenvironment

Patients with BPPV often already have an impaired microenvironment in the vestibular portion of the inner ear, which contributes to otolith detachment. Even after successful repositioning of the otoliths, the inner ear’s microenvironment may take time to improve. Therefore, symptoms such as persistent drowsiness or mental fogginess may continue for a period. This is generally considered normal and will typically resolve on its own over time. Medications such as betahistine mesylate tablets or ginkgo biloba leaf tablets may be used as directed by a physician.

5. Hypertension

Conditions such as hypertension may impair cerebral blood supply, leading to persistent dizziness. Timely management is necessary, and medications such as enteric-coated aspirin tablets or clopidogrel hydrogen sulfate tablets may be used under medical supervision to relieve symptoms.

In addition, Ménière’s disease may also cause persistent dizziness even six months after BPPV repositioning. If patients experience discomfort, they should seek prompt medical evaluation for targeted treatment to avoid delays in managing their condition.