What is Benign Paroxysmal Positional Vertigo (BPPV)?
Jul 19, 2025
Source: Cainiu Health
Dr. Lu Cheng
Introduction
Under normal circumstances, otolith disease may be caused by factors such as age-related degeneration of the otoliths, head trauma, insufficient blood supply to the inner ear, viral labyrinthitis, or middle ear infection affecting the inner ear. It is recommended to seek timely medical attention, identify the underlying cause, and undergo symptomatic treatment under a doctor's guidance. In daily life, one should avoid sudden or vigorous head movements, bowing, or tilting the head backward to reduce the likelihood of symptom episodes.
Generally, otolith syndrome may be caused by factors such as age-related degeneration of otoliths, head trauma with concussion, insufficient blood supply to the inner ear, viral labyrinthitis, or otitis media extending to the inner ear. It is recommended to seek timely medical consultation to determine the exact cause and receive appropriate treatment under a physician's guidance. Detailed explanations are as follows:
1. Age-related degeneration of otoliths: With aging, the otoliths on the macula of the utricle in the inner ear may degenerate and detach, entering the semicircular canals and causing symptoms, commonly seen in middle-aged and elderly individuals. During symptom episodes, one should sit or lie down immediately to prevent falls. After symptoms subside, otolith repositioning exercises can be conducted under a physician's guidance.
2. Head trauma and concussion: Head injuries caused by impacts or falls may lead to violent shaking of the head, causing the otoliths to dislodge and shift positions. Symptoms may appear days or weeks after the injury. Rest should be taken after injury, and vigorous activities should be avoided. Timely otolith repositioning treatment should be performed when symptoms are evident.
3. Insufficient blood supply to the inner ear: Hypertension, arteriosclerosis, and other conditions may impair blood circulation in the inner ear, leading to inadequate nutrient supply to the macula of the utricle, making otoliths prone to detachment. Symptoms may include dizziness and tinnitus. Active management of blood pressure and lipid levels is necessary. Medications such as Ginkgo biloba extract tablets, betahistine mesylate tablets, and flunarizine hydrochloride capsules may be used as prescribed to improve inner ear blood supply.
4. Viral labyrinthitis: Viral infections may cause inflammation in the inner ear, with inflammatory irritation leading to otolith detachment, accompanied by vertigo and hearing loss. Patients may take acyclovir tablets, betahistine hydrochloride oral solution, and mecobalamin tablets as directed by a physician. These treatments can be combined with otolith repositioning procedures to restore the otoliths' positions.
5. Otitis media involving the inner ear: Untreated middle ear infections may spread to the inner ear, damaging the structures to which the otoliths are attached, causing them to detach. Symptoms may include ear pain and pus discharge. Patients should use medications such as cefixime dispersible tablets, ofloxacin ear drops, and prednisone tablets as directed by a physician to control infection. Otolith repositioning treatment can be performed after infection is controlled. In severe cases, tympanoplasty may be required to remove the lesion and prevent further damage to the inner ear.
In daily life, sudden and vigorous head movements, such as rapid turning, bending forward, or tilting the head backward, should be avoided to reduce symptom episodes. Slow down when getting up or lying down, maintain regular作息 habits, and avoid excessive fatigue. Engage in appropriate balance training, such as standing on one leg or slowly turning the head, to enhance inner ear stability.
