They said it's not BPPV. But why do I keep feeling dizzy? | Incheon BPPV Dizziness

"They say it's not BPPV" — But why am I still dizzy?

The elusive dizziness you can't quite pinpoint, a journey to find its true cause

"Doctor, my eyes aren't spinning... but I feel like my head is floating."
"The floor feels like it's moving, and I keep swaying."
"I had a CT scan and they said it's not BPPV, but... what on earth is this?"

I hear these words from my patients very often. They've been told by the ENT department, "It's not BPPV. There's nothing particularly wrong," but their body still feels unstable, and the dizziness persists.

Today, I want to talk about that feeling of dizziness you still experience—even though it's not BPPV, not Meniere's disease, and your blood pressure is normal.

[1. The World of Undiagnosed Dizziness]

Medically, dizziness is a common symptom, but it's also one of the most difficult and ambiguous symptoms to diagnose. Many patients say, "They say it's not BPPV," which can often be a euphemism for not having received an accurate diagnosis.

In reality, rather than BPPV being a condition that can be definitively diagnosed, it's often retrospectively concluded as "it must have been BPPV" when specific symptoms improve with a repositioning maneuver. In other words, the diagnosis is reconstructed based on the success of a treatment. However, this interpretation can be logically backward and may not explain all the causes of the symptoms.

[2. The Truth Within Dizziness, as Described by Patients]

Doctors speak of "vertigo" or "vestibular dizziness," but patients describe it like this:

"It's not lightheadedness, but I feel like my eyes are unsteady."
"When I go down stairs, it feels like my body isn't following."
"My gaze is fixed, but my center keeps swaying."
"The back of my head feels numb inside, and my vision is blurry."
"A feeling of anxiety comes first, then the dizziness washes over me."

If we look closely at these expressions, we can see that it's a complex phenomenon involving not just ear issues, but also the brain, vision, emotions, and the autonomic nervous system. When asked about the circumstances under which the dizziness began, it's often accompanied by non-vestibular factors such as stress, lack of sleep, prolonged tension, and emotional fluctuations.

[3. What's More Important Than a Diagnosis: A Map of Sensation]

The medical system is accustomed to assigning 'disease names,' but the body's condition often cannot be explained by a single diagnosis. If it's not BPPV, then what could be the other causes?

Generally, these possibilities should be considered:

• Autonomic nervous system imbalance: a state where the sympathetic nervous system is overactivated, leading to unstable cerebral blood flow
• Sensory integration failure: sensory information from the eyes, ears, soles of the feet, etc., is not properly integrated in the central nervous system
• Brain fog-type dizziness: slowed thinking speed, impaired cognitive function, and inability to feel one's body's center
• Psychogenic factors: perceived imbalance that appears as anxiety transferred to physical symptoms

What's important here is to understand, like a map, "where exactly is my body's sensory system going awry right now?"

[4. Language and Direction for Recovery]

As dizziness is a sensory issue, reconnecting those sensations is necessary for recovery. Beyond simply taking medication or repeatedly performing repositioning maneuvers, it requires 're-educating the senses' and 'routines to stabilize the autonomic nervous system.'

The following training is necessary:

• Oculovestibular retraining: exercises that integrate eye movements and head turns
• Plantar sensory stimulation: routines that help the body re-recognize information from the ground
• Breathing stabilization routines: restoring sympathetic-parasympathetic balance through diaphragmatic breathing and rhythm
• Emotional interpretation training: recognizing and breaking the link between dizziness and anxiety

The core of all these processes is to help the body feel its own center again.

Just because it's not BPPV doesn't mean your dizziness is fake. Even if a diagnostic label isn't attached, your body is clearly experiencing some imbalance. That dizziness is your body's signal that "something is out of alignment."

What's needed now is not more tests or more names, but a map that can reconnect and interpret your sensations. Your dizziness is by no means a trivial matter. But a path can be found. Together, let's draw that map.

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