the presence of calculi in the cupula of the posterior semicircular duct.
be·nign par·ox·ys·mal positional ver·ti·go
a recurrent, brief form of positional vertigo occurring in clusters; believed to result from displaced remnants of utricular otoconia into the semicircular ducts, usually the posterior.
benign paroxysmal positional vertigoA form of transient vertigo caused by utricular degeneration which liberates otoconia: otoconia drift into the lower part of the vestibule, the ampulla of the posterior semicircular canal; once there, the otoconia alter the cupola’s specific gravity, changing its response characteristics from a purely angular acceleration detector to one that is stimulated by linear movements and gravity.
BPPV is a common form of vertigo, more common in older adults.
Closed head injury, vestibular neuronitis, infections, post-stapedectomy.
History—e.g., single bouts of severe vertigo of < 1 min in duration after a change in head position, often more severe on one side, when bending, looking to take an object off a shelf or tilting the head back; the episodes are clustered in time and separated by remissions lasting months or more; Hallpike maneuver.
Particle repositioning maneuver; occlusion of affected canal using a bone chop:fibrinogen glue plug; most BPPV resolves spontaneously within several months of onset, especially following head injury; persistent, near-disabling symptoms may mandate surgery: singular neurectomy, vestibular neurectomy or posterior semicircular canal occlusion.