What are the consequences of not treating otolithiasis?

Under normal circumstances, benign paroxysmal positional vertigo (BPPV) is a vestibular disorder caused by dislodged otoliths. If left untreated, it can continuously affect quality of life. Major consequences include frequent episodes of dizziness, impaired balance, increased risk to personal safety, psychological issues, and the development of other discomfort symptoms. A detailed analysis is as follows:

1. Frequent dizziness attacks: When otoliths remain displaced, even minor head movements may trigger vertigo. During an episode, patients experience intense spinning sensations, often accompanied by nausea and vomiting. Initially, symptoms may only occur during actions like rolling over in bed or bending the head forward; however, over time, attacks become more frequent and may be triggered even by routine activities such as walking or turning the head, severely disrupting daily functioning.

2. Impaired balance function: Prolonged dizziness leads to persistent vestibular dysfunction and reduced balance perception. Patients often exhibit unsteady gait, body swaying while walking, and need to hold onto objects for stability when standing. They may also struggle with fine motor tasks, affecting limb coordination.

3. Increased risk to personal safety: Sudden vertigo attacks increase the likelihood of accidents. For example, falling while climbing stairs, or causing traffic accidents when driving or cycling. Even routine household activities—such as fetching water or cooking—can lead to collisions or burns if a vertigo episode occurs.

4. Development of psychological problems: Frequent dizziness and discomfort can cause fear and anxiety about sudden attacks, leading patients to avoid physical activity. This may result in increasing anxiety, irritability, and social withdrawal, which in turn fosters loneliness. A vicious cycle can develop: fear of movement leads to greater anxiety, which amplifies symptom perception.

5. Induction of other discomfort symptoms: Persistent vestibular stimulation may affect head nerves, causing headaches and a sensation of heaviness in the head. Some patients experience loss of appetite due to repeated nausea, resulting in fatigue and low spirits. Others may develop sleep disturbances due to fear of an attack occurring during sleep.

Treatment for BPPV is generally straightforward. It is recommended that patients seek timely medical attention and undergo otolith repositioning maneuvers once symptoms appear. In daily life, movements should be performed slowly, avoiding rapid head turns or低头 movements. Adopting appropriate sleeping positions can help reduce triggers and support recovery of vestibular function.