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DIZZINESS CLINIC

"The world is suddenly spinning —
is it BPPV, or a brain problem?"

80% of dizziness originates from causes other than the ear
Without assessing both peripheral and central causes, it will recur

ANSWER

"The cause of dizziness is not limited to the ear.
You need to examine the brain and autonomic nervous system to find the answer."

OSANG does not simply suppress symptoms — we trace the root cause of dizziness from multiple angles.

To break the vicious cycle of recurring dizziness, we design a personalized 'balance recovery pathway' for each patient.

Dizziness Clinic - BPPV, Vestibular Neuritis, Cerebrovascular Vertigo Treatment | OSANG Neurosurgery

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If you experience recurring dizziness,
you need specialized care

Just turning my head makes the world spin — I'm afraid to move.
Suddenly my vision goes dark and I feel like I might collapse.
Along with dizziness, I hear ringing in my ears and they feel blocked.
When walking, I keep veering to one side and it makes me anxious.
Know Your Dizziness

You must first identify
the exact cause of your dizziness

01 BPPV (Benign Paroxysmal Positional Vertigo) BPPV

Displaced otoliths in the semicircular canal cause brief (seconds to 1 minute) rotational vertigo when turning the head or lying down. The most common cause of dizziness, quickly improved with canalith repositioning.

Canalith Repositioning Epley Maneuver Recurrence Prevention
02 Vestibular Neuritis VESTIBULAR NEURITIS

Viral inflammation of the vestibular nerve causes sudden severe rotational vertigo with nausea and vomiting lasting several days. Recovery is achieved through acute-phase medication and vestibular rehabilitation.

Acute Medication Vestibular Rehab Balance Training
03 Meniere's Disease MENIERE'S DISEASE

Excess inner ear lymph fluid causes recurring episodes of dizziness, tinnitus, hearing loss, and ear fullness lasting minutes to hours. Dietary management, medication, and vestibular rehabilitation are combined to reduce attack frequency.

Low-sodium Diet Diuretics Vestibular Suppressants Hearing Management
04 Orthostatic / Autonomic ORTHOSTATIC / AUTONOMIC

A sudden drop in blood pressure upon standing causes blackout and lightheadedness. Caused by autonomic nerve imbalance, confirmed through HRV testing, followed by autonomic stabilization therapy.

Autonomic Testing HRV Tilt Table Test Lifestyle Modification
05 Central Vertigo CENTRAL VERTIGO

Caused by brainstem, cerebellar, or cerebrovascular abnormalities, potentially accompanied by headache, visual disturbance, and gait disorder. Immediate MRI/MRA imaging and differential diagnosis are essential.

Brain MRI/MRA Cerebrovascular Evaluation Neurosurgery Collaboration
Neurosurgery × Neurology

Dizziness: Why two specialists
need to work together

Dizziness is not just an ear (vestibular) problem. Structural issues such as the brainstem, cerebellum, and cervical spine, along with functional issues like the vestibular nerve, autonomic nerves, and cerebral blood flow, are complexly intertwined.
At OSANG, two specialists in neurosurgery and neurology work together to simultaneously differentiate peripheral and central causes.

STRUCTURE

Neurosurgery

  • Brainstem and cerebellar structural assessment
  • Cervicogenic dizziness correction
  • Cerebrovascular stenosis and malformation differentiation
  • C-arm guided precision procedures
  • Surgical treatment evaluation

FUNCTION

Neurology

  • Vestibular function testing and nystagmus analysis
  • Autonomic nerve balance regulation
  • Vestibular rehabilitation program design
  • Cerebral blood flow assessment
  • Customized medication planning and monitoring
Peripheral Differentiation Central Differentiation Vestibular Rehab Autonomic Regulation Emergency Assessment
Quick Comparison

How do you distinguish between
BPPV and vestibular neuritis?

Category BPPV (Benign Paroxysmal Positional Vertigo) Vestibular Neuritis Meniere's Disease
Vertigo Pattern Brief spinning with position change Sudden severe rotational vertigo Recurring vertigo + tinnitus
Duration Seconds to 1 minute Hours to days Minutes to hours
Triggers Head turning, lying down, standing up None (sudden onset) Stress, overwork, high-sodium diet
Hearing Impact None None Hearing loss and ear fullness
Nausea/Vomiting Mild Severe Moderate
Main Treatment Canalith Repositioning Medication + Vestibular Rehab Diet + Medication + Rehab
Self Check

Self-Check: Dizziness Checklist

If 3 or more apply, get a professional consultation
FAQ

Frequently Asked Questions

Q. How can I tell if my recurring dizziness is BPPV or not?
BPPV is characterized by brief (seconds to 1 minute) rotational vertigo triggered by position changes such as turning the head or lying down. If dizziness occurs even at rest or lasts for hours, it may be due to vestibular neuritis, Meniere's disease, cerebrovascular issues, or other causes.
Q. Can dizziness be treated at a neurosurgery clinic?
Yes. Dizziness may originate from structural problems in the brainstem, cerebellum, or cervical spine, making neurosurgical evaluation essential. OSANG Neurosurgery diagnoses both structural and functional aspects through collaborative neurosurgery-neurology care.
Q. What is vestibular neuritis? Does it resolve naturally?
Vestibular neuritis is a condition where viral inflammation of the vestibular nerve causes sudden severe rotational vertigo, nausea, and vomiting. The acute phase is managed with medication, followed by vestibular rehabilitation for recovery. Without treatment, it can lead to chronic imbalance.
Q. How are Meniere's disease and BPPV different?
BPPV causes a spinning sensation lasting seconds to 1 minute with position changes and does not affect hearing. Meniere's disease involves dizziness lasting minutes to hours accompanied by tinnitus, hearing loss, and ear fullness. Vestibular function tests and audiometry are needed for accurate differentiation.
Q. Can dizziness caused by orthostatic hypotension be treated?
Yes. Orthostatic hypotension is often caused by autonomic nervous system dysfunction. OSANG Neurosurgery identifies the cause through autonomic testing (HRV, etc.) and improves dizziness through a combination of autonomic stabilization therapy and lifestyle modification.
Q. Does dizziness with headache indicate a brain problem?
When dizziness and headache occur together, central causes such as vestibular migraine and cerebrovascular abnormalities must be ruled out. Immediate specialist consultation is needed especially if accompanied by visual disturbance, speech difficulty, or unilateral paralysis.
Q. What is canalith repositioning? Is one session enough?
Canalith repositioning is a physical treatment that returns displaced otoliths (calcium crystals in the ear) to their original position. About 70-80% of patients improve with 1-2 sessions, and it can be repeated if recurrence occurs.
Q. How does vestibular rehabilitation therapy work?
Vestibular rehabilitation is an exercise-based therapy that utilizes the brain's adaptive ability (plasticity) to compensate for damaged vestibular function. It gradually improves dizziness and imbalance through eye exercises, balance training, and gait training.
Q. Is dizziness treatment difficult for elderly patients?
Although elderly patients often have multiple contributing factors such as vestibular function decline, multisensory loss, and medication side effects, improvement is achievable through cause-specific treatment and vestibular rehabilitation. Active treatment is important as neglect increases fall risk.
Q. Can the cause of dizziness be identified without MRI or CT?
While clinical diagnosis is possible in some cases like BPPV through characteristic nystagmus (eye tremor), MRI/MRA imaging is recommended to rule out central causes. OSANG Neurosurgery performs nystagmus tests, vestibular function tests, autonomic nerve tests, and precision imaging when necessary.
Q. What tests are performed during a dizziness consultation?
Tests include nystagmus testing (Dix-Hallpike, Head impulse), vestibular function testing (VNG/ENG), autonomic testing (HRV, tilt table test), audiometry, and brain MRI/MRA when needed. Results are comprehensively analyzed to differentiate peripheral and central causes.
Q. What is different about having neurosurgery and neurology work together?
Neurosurgery specializes in evaluating structural causes such as the brainstem, cerebellum, and cervical spine, while neurology focuses on functional causes including the vestibular nerve, autonomic nerves, and cerebral blood flow. When both specialists work together, peripheral and central causes are simultaneously differentiated, improving treatment accuracy and speed.

Consultation

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