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Dizziness: Is it an Ear Problem or a Brain Problem? The Answer to Mysterious Spinning is Here!

Have you ever experienced dizziness where the world spins suddenly, you feel like you're floating, or everything goes dark and you stagger? Many people visit hospitals for these symptoms, but are often frustrated when tests show "nothing unusual." Dizziness can seriously disrupt daily life and, in severe cases, make you afraid to even go out for fear of falling. The anxiety is even greater when you can't tell if the cause of the dizziness is an ear problem or a brain problem.

💡 [Key Answer] 3 Most Common Causes of Dizziness: ① Autonomic Imbalance / ② Peripheral Vestibular Dysfunction (BPPV, Meniere's, etc.) / ③ Central Nervous System Problems (Brain tumor, Cerebral infarction, etc.) Dalimchae Korean Medicine Clinic focuses on the instability of the autonomic nervous system that causes mysterious dizziness, providing a solution by helping the brain regain balance on its own.

In many cases, even if you visit a hospital for dizziness and undergo precision tests such as MRI or CT, no special abnormalities are found. This is highly likely because the cause of the dizziness lies in a functional problem that is difficult to confirm with imaging tests. Our body's autonomic nervous system automatically regulates functions essential for life, such as heart rate, blood pressure, digestion, and body temperature, without my conscious awareness. If this autonomic balance is broken due to stress, overwork, or chronic fatigue, blood flow to the brain becomes unstable and confusion arises in the system that regulates our body's sense of balance, leading to dizziness.

Particularly, cases of dizziness in the form of orthostatic hypotension, where everything goes dark when sitting up, or dizziness accompanied by chronic fatigue, are closely related to autonomic dysfunction. Minute functional abnormalities of the brain and whole-body organs may not easily be revealed by general tests alone, and this is one of the main reasons for receiving a diagnosis of "unknown cause."

Dizziness can be broadly divided into ear problems (peripheral), brain problems (central), and autonomic nervous system problems.

• Ear Problems (Peripheral Dizziness): Mainly occurs due to problems inside the ear, such as the vestibular organ and vestibular nerve. Representative diseases include BPPV (Benign Paroxysmal Positional Vertigo), Meniere's disease, and vestibular neuritis. Characteristically, rotational dizziness, as if the surroundings are spinning, appears severely, and may be accompanied by vomiting, nausea, tinnitus, and hearing loss. Symptoms appear suddenly and tend to worsen when moving the head or posture in a specific direction.

• Brain Problems (Central Dizziness): Occurs due to abnormalities in the central nervous system, such as the brainstem and cerebellum. Stroke, brain tumors, and migraine-associated vertigo fall into this category. The intensity of dizziness is less than that of peripheral dizziness, but it is often accompanied by neurological symptoms such as loss of balance, visual abnormalities, limb paralysis, and speech disorders. These symptoms can be an emergency, so immediate precision testing is required.

• Autonomic Problems: In many cases where no abnormalities are found in hospital tests but the patient suffers from chronic dizziness, autonomic imbalance is the main cause. This is a problem with the brain's blood circulation and neurotransmission due to unstable functioning of the autonomic nervous system from stress or overwork, rather than a structural problem in a specific area. A significant number of patients who complain, "I'm dizzy but don't know if it's an ear problem or a brain problem," belong to this type.

Our body's autonomic nervous system consists of the sympathetic and parasympathetic nervous systems, and when the balance between the two is broken, various physical symptoms appear. Dizziness, in particular, is greatly affected by sensitive changes in the autonomic nervous system. If the sympathetic nervous system is excessively activated due to accumulated stress or fatigue, blood vessels can constrict and blood circulation can decrease. This interferes with the supply of oxygen and nutrients to the brain, inducing dizziness. Additionally, autonomic instability causes minute functional abnormalities in the brainstem area, leading to problems in communication between the brain and the vestibular organs that regulate the sense of balance.

In fact, according to a case report published in the 『Journal of Korean Medicine』 in 2023, as a result of administering Korean medicine treatment, including herbal medicine, acupuncture, and moxibustion, for 29 days to one dizziness patient accompanied by orthostatic hypotension, improvement was seen in the patient's subjective complaint of dizziness and on the NRS (Numeric Rating Scale). The decrease in blood pressure according to postural changes also lessened, confirming the improvement of orthostatic hypotension. The researchers concluded that Korean medicine treatment can have a significant effect on improving blood pressure changes and dizziness symptoms even in situations where it is difficult to stop taking medication. These research results suggest the effectiveness of a Korean medicine approach to dizziness related to autonomic dysfunction.

Similar results can be found in a study of one case of Persistent Postural-Perceptual Dizziness (PPPD) reported in the 『Journal of Internal Korean Medicine』, another recent research case. This patient complained of non-specific dizziness that persisted even after the Epley maneuver, which was suspected to be due to autonomic nervous system abnormalities. For the patient, who had not improved despite medication and rehabilitation for more than 9 months since the onset of symptoms in 2021, applying a Korean medicine treatment utilizing modified Banhabaekchulcheonma-tang for 20 days of inpatient treatment resulted in continuous improvement, with dizziness symptoms reduced by about half. Through this case, the researchers presented the possibility of Korean medicine treatment for intractable dizziness such as PPPD, which is heavily influenced by the autonomic nervous system. This data is the reason why Dalimchae Korean Medicine Clinic does not view dizziness as a simple symptom, but focuses on treatment that corrects the deep-rooted imbalance of the autonomic nervous system.

At Dalimchae Korean Medicine Clinic Incheon Branch, to identify the cause of dizziness, we go beyond simple symptom inquiry and closely analyze the patient's constitution, lifestyle, stress level, and the current state of the autonomic nervous system. Through pulse wave tests and autonomic nervous system tests, we objectively understand the body's state of balance and, based on this, establish an optimized treatment plan for the individual.

Dalimchae Korean Medicine Clinic's dizziness treatment focuses on autonomic stabilization. "When the balance of the autonomic nervous system is broken, the brain cannot rest." If the brain remains in a state of tension like an overheated engine, minute blood flow disorders or neurotransmission imbalances occur, inducing dizziness. At Dalimchae Korean Medicine Clinic, we reduce this overload on the brain and nervous system and provide treatment that creates an environment where it can recover on its own.

Lowering the heat in the nervous system and creating an environment where the brain can rest—in Korean medicine, this is called Suseunghwagang (水昇火降)—is the process of stabilizing the excessively heightened sympathetic nervous system and activating the function of the parasympathetic nervous system to regain autonomic balance. Through this, we facilitate smooth blood circulation in the brain, increase stress resistance, and solve the fundamental cause of dizziness.

At our Dalimchae Korean Medicine Clinic Incheon Branch, many people complain of headaches, tinnitus, or insomnia along with dizziness. These are often closely related to autonomic instability, and you can experience improvement in these accompanied symptoms while treating dizziness.

If 3 or more of the following items apply, it is recommended to suspect autonomic dizziness and consider Dalimchae Korean Medicine's complex treatment. If 5 or more apply, immediate visit is recommended.

• Everything goes dark and I feel lightheaded when I suddenly stand up.
• Dizziness worsens when I am stressed or tired.
• I have symptoms of headache, tinnitus, or heart palpitations along with dizziness.
• No special cause was found in hospital tests.
• I don't feel refreshed even after sleeping enough and suffer from chronic fatigue.
• I have symptoms of bloating or poor digestion.
• I am sensitive and anxious, so I am easily startled by small things.
• The back of my neck or shoulders are often stiff and my neck feels rigid.

Q. How long does dizziness treatment take? A. The treatment period may vary depending on the cause of the dizziness, the severity of the symptoms, and the individual's constitution. In most cases, it gradually improves through consistent treatment for several weeks to several months.

Q. Can BPPV also be cured with Korean medicine treatment? A. BPPV is a peripheral dizziness that occurs when otoliths within the vestibular organ leave their place. In Korean medicine, we can help reduce discomfort and prevent recurrence through herbal prescriptions and acupuncture treatment effective in alleviating dizziness and accompanied symptoms (vomiting, nausea, etc.) caused by BPPV.

Q. Will dizziness get better naturally if left alone? A. Temporary dizziness can improve with sufficient rest, but chronic or mysterious dizziness can worsen or become chronic if left untreated. In particular, dizziness due to autonomic imbalance is difficult to heal naturally without solving the fundamental cause.

Q. I have headache and dizziness together; can they be treated together? A. Yes, headaches and dizziness often share common causes such as autonomic imbalance and brain blood flow problems. Dalimchae Korean Medicine's autonomic stabilization treatment is effective in improving both symptoms together.

Dizziness is not a problem that can be solved by enduring. You no longer have to ignore the signals your body has been sending for a long time. If you approach it in the right direction, your body will react faster than you think. Bring your symptoms as they are. Dalimchae Korean Medicine Clinic will find the cause together.

Where life blooms. For herbal medicine, it's Dalimchae Korean Medicine Clinic. Check your symptoms similar to mine through the AI consultation on the Dalimchae Korean Medicine Clinic website first!

This article is health information compiled by Dalimchae medical staff based on questions frequently received in the treatment room. Medical Supervision | Incheon Branch Korean Medicine Doctor Min Jihong (Dizziness Column) based on Brain/Autonomic nervous system treatment standards.