Q My BPPV keeps coming back two or three times a year. Is it normal for it to recur like this, or is something wrong?
A BPPV responds well to repositioning maneuvers, but its annual recurrence rate is relatively high, at 30-50%. If recurrence is frequent, rather than simply repeating the repositioning maneuver, the key to lengthening the interval between recurrences is to also address the bodily state and lifestyle factors that keep causing the otoliths to come loose.
Detailed Answer
For people who have had BPPV once, the rate of it recurring within a year is not small, at 30-50%. Osteoporosis, vitamin D deficiency, repeated lack of sleep, chronic fatigue, and head trauma are known to raise the risk of recurrence. Repeating the repositioning maneuver alone controls acute attacks, but to reduce recurrence itself, you need to manage the background factors that make the otoliths unstable. Vestibular rehabilitation exercises such as the Brandt-Daroff exercise help prevent recurrence.
Korean Medicine Clinic Perspective
Dongjedang links frequent recurrence to internal constitutional backgrounds such as dameum, deficient qi and blood, and Kidney deficiency (sinheo). By resolving the dameum that disturbs inner-ear lymphatic circulation and replenishing qi and blood, an inner-ear environment is created in which the crystals are less likely to come loose, lengthening the interval between recurrences. We recommend combining several weeks of Korean medicine treatment after a canalith repositioning maneuver to reduce the frequency of recurrence.
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